One of the great modern misconceptions is that Change is good for us. Change is neutral. Good change is good, bad change is not good. Before jumping on the change bandwagon, people need to evaluate whether it is a good change which leads to benefits or something that is useless or may actually be worse. This seems to be something few people other than ethical scientists actually do. Most people just want any change, ANY change that might give them hope and mend their broken lives and bodies. Calling something Progress gives people hope by implying it will be good change. By the time they realize it also didn’t work they will be on to the next promised miracle cure.
This was excellent! I’ve been following this subject for several years wondering if it was it was something that could help me. The jama study, your jama response, and Dr Kristin Rojas who runs the m.u.s.i.c program were the three strike reasons I didn’t try it. Thank you, you’ve saved me $ and potentially from harm.
Thank you for marching us through the updates. Desperation leads to poor decision making, and one becomes vulnerable to frauds. Thank you for pulling folks back toward their OWN best interests.
Great post, keeping it real (which is so rare in this age of fake science.) You make a great point about the sunk cost fallacy. I’ve seen similar among physical therapy groups who encourage modalities that they will be able to charge insurance for to help pay for the machine. (I had this with an ankle injury and was burned by the laser— switched PTs and did actual work to rehab the ankle, fixing suboptimal movement patters.)
After your last post I started looked more closely at the social media influencers who claim to be “board certified dermatologists” hawking estriol face cream (and a whole bunch of other stuff.) I have not gone so far as to research their actual qualifications (i.e., are they even really doctors? Don’t they have practices IRL? Why are they making videos all day long—? At last check, real dermatologists are busy and make plenty of money.) I realize that by clicking on these ads disguised as helpful posts I’m inviting more of them into my social media feeds, which may warp my sense of their prevalence, but I see a lot of other MDs, or people who claim to be, as influencers, in other areas. I can see the point of trying to messages for good in the world, or to promote well-researched books designed to be read by the general public but product promotion is a huge conflict of interest.
THANK YOU for this. I printed out information about vaginal laser therapy for my last GYN apportionment. She said the same thing - there hasn't been a good study that proves this works, and it could cause (burns) harm. She said they had discussed getting the Mona Lisa equipment at her facility, but they decided against it. Whew! The problem around all of this is that so few real studies have been done on new methods, and so little is available to bring relief! I myself use multiple therapies (recommended through my GYN), like Revaree but that's so expensive - I also use Yuvafem, and low dose compounded HRT. And I still sometimes have issues, it's very discouraging. So I do understand why women are so ready to try new therapies, but I also realize that there has to be better studies, and so many companies want to rip us off.
1) Laser vag tx goes back way before 2015. I heard people talking about it at a conference about 10 yrs before that. I don't remember the speaker's topic, but NPs in the audience brought it up in discussion -- with anectdotal evidence...
2) I was wondering whether a scumbag MD I know was offering that, so I googled his name + vag. laser tx (I didn't find that he is), but I found a site in Tulsa, OK, claiming that 'highly trained professionals' at the site perform the procedure, and that it is 'safe & effective' as demonstrated by 'clinical trials' and pt satisfaction...
and another place in Sioux City, SD
3) Oddly enough, google also brought me to references that said 'stay away from this' and a Harvard U. (!) enty saying it works.
I love your evidence based information and content and think you are making a huge difference in the area of women's health, which seems more important now than ever. I wish all providers that address women's health issues would practice that way - it would make healthcare for women better.
I was suckered by a gyn into getting Mona Lisa and PRP because I had unresolved pain and itch. It cost about 5k. When I went to look it up, I didn't understand how Google is optimised by companies, and I certainly didn't understand what made a good study, etc. It looked really good online. Had the treatments with no resolution, so I went to another provider who told me the truth. My current gyn also explained that the practice would have spent over 100k, so they push it on all their patients. Thank god for my old school gyn, who also diagnosed my LS.
Thanks for the update. I have lichen sclerosus (newly diagnosed) and have seen some touting of laser to treat it. While thankfully I respond well to the gold-standard treatment (steroid ointment), it would be great to have a one-and-done treatment. Would you consider writing about laser for LS and LS in general? I'd appreciate some evidence-based info.
Thank you so much for all you do to promote women’s health with evidence based information. I wonder if you might consider a post regarding UroSpot or Esmella treatments for incontinence? I’ve been using Urestra (thank you for that information too!) but would love to have improved bladder control without the need for any device. However, the information I found on these treatments seems too good to be true. I’d really love to hear the “Dr. Jen” take on them as I trust and value your insight.
So glad to hear this. Saw some people (many!) promoting vaginal laser for the past few years. Can’t say the idea of lasers near my vagina appealed to me, but I did wonder if I might be shunning an effective treatment. I’m clearly not. I’ll stick with my Premarin cream that has been studied and is effective. Seriously, it gave me my back life.
If you want to make your mind explode a little (not in a good way) check out the many ‘summits’ offered through DrTalks. I was getting advertisements for about one of these a week, many targeting ‘women’s issues.’ I learned it’s primarily supplements, bioidentical hormones, and unproven technologies/treatments (like laser), brought to you by the people who invented/sell/offer them. So basically it’s like a 2-5 day infomercial in interview format. Quite slick, and meant to look like it’s all safe and effective—I mean, it’s all doctors, right? That are talking? The tone I got was that safe and proven treatments are ‘old fashioned.’ Premarin is laughed at because ‘it’s from pregnant mares!’ and so could only be inferior to a bioidentical product. It’s an interesting way to market, I suppose.
I’m wondering if you looked into Thermiva at all (not a laser). My gyno said she was getting good results for dryness for ppl for whom hrt is not enough.
One of the great modern misconceptions is that Change is good for us. Change is neutral. Good change is good, bad change is not good. Before jumping on the change bandwagon, people need to evaluate whether it is a good change which leads to benefits or something that is useless or may actually be worse. This seems to be something few people other than ethical scientists actually do. Most people just want any change, ANY change that might give them hope and mend their broken lives and bodies. Calling something Progress gives people hope by implying it will be good change. By the time they realize it also didn’t work they will be on to the next promised miracle cure.
This is an excellent summary!! Thank you!
This was excellent! I’ve been following this subject for several years wondering if it was it was something that could help me. The jama study, your jama response, and Dr Kristin Rojas who runs the m.u.s.i.c program were the three strike reasons I didn’t try it. Thank you, you’ve saved me $ and potentially from harm.
Thank you for marching us through the updates. Desperation leads to poor decision making, and one becomes vulnerable to frauds. Thank you for pulling folks back toward their OWN best interests.
Great post, keeping it real (which is so rare in this age of fake science.) You make a great point about the sunk cost fallacy. I’ve seen similar among physical therapy groups who encourage modalities that they will be able to charge insurance for to help pay for the machine. (I had this with an ankle injury and was burned by the laser— switched PTs and did actual work to rehab the ankle, fixing suboptimal movement patters.)
After your last post I started looked more closely at the social media influencers who claim to be “board certified dermatologists” hawking estriol face cream (and a whole bunch of other stuff.) I have not gone so far as to research their actual qualifications (i.e., are they even really doctors? Don’t they have practices IRL? Why are they making videos all day long—? At last check, real dermatologists are busy and make plenty of money.) I realize that by clicking on these ads disguised as helpful posts I’m inviting more of them into my social media feeds, which may warp my sense of their prevalence, but I see a lot of other MDs, or people who claim to be, as influencers, in other areas. I can see the point of trying to messages for good in the world, or to promote well-researched books designed to be read by the general public but product promotion is a huge conflict of interest.
THANK YOU for this. I printed out information about vaginal laser therapy for my last GYN apportionment. She said the same thing - there hasn't been a good study that proves this works, and it could cause (burns) harm. She said they had discussed getting the Mona Lisa equipment at her facility, but they decided against it. Whew! The problem around all of this is that so few real studies have been done on new methods, and so little is available to bring relief! I myself use multiple therapies (recommended through my GYN), like Revaree but that's so expensive - I also use Yuvafem, and low dose compounded HRT. And I still sometimes have issues, it's very discouraging. So I do understand why women are so ready to try new therapies, but I also realize that there has to be better studies, and so many companies want to rip us off.
1) Laser vag tx goes back way before 2015. I heard people talking about it at a conference about 10 yrs before that. I don't remember the speaker's topic, but NPs in the audience brought it up in discussion -- with anectdotal evidence...
2) I was wondering whether a scumbag MD I know was offering that, so I googled his name + vag. laser tx (I didn't find that he is), but I found a site in Tulsa, OK, claiming that 'highly trained professionals' at the site perform the procedure, and that it is 'safe & effective' as demonstrated by 'clinical trials' and pt satisfaction...
and another place in Sioux City, SD
3) Oddly enough, google also brought me to references that said 'stay away from this' and a Harvard U. (!) enty saying it works.
I love your evidence based information and content and think you are making a huge difference in the area of women's health, which seems more important now than ever. I wish all providers that address women's health issues would practice that way - it would make healthcare for women better.
I was suckered by a gyn into getting Mona Lisa and PRP because I had unresolved pain and itch. It cost about 5k. When I went to look it up, I didn't understand how Google is optimised by companies, and I certainly didn't understand what made a good study, etc. It looked really good online. Had the treatments with no resolution, so I went to another provider who told me the truth. My current gyn also explained that the practice would have spent over 100k, so they push it on all their patients. Thank god for my old school gyn, who also diagnosed my LS.
So sorry this happened to you.
Thanks for the update. I have lichen sclerosus (newly diagnosed) and have seen some touting of laser to treat it. While thankfully I respond well to the gold-standard treatment (steroid ointment), it would be great to have a one-and-done treatment. Would you consider writing about laser for LS and LS in general? I'd appreciate some evidence-based info.
Thank you so much for all you do to promote women’s health with evidence based information. I wonder if you might consider a post regarding UroSpot or Esmella treatments for incontinence? I’ve been using Urestra (thank you for that information too!) but would love to have improved bladder control without the need for any device. However, the information I found on these treatments seems too good to be true. I’d really love to hear the “Dr. Jen” take on them as I trust and value your insight.
I don't think the data is very good, but admittedly I haven't looked in a while. Let me check into it!
So glad to hear this. Saw some people (many!) promoting vaginal laser for the past few years. Can’t say the idea of lasers near my vagina appealed to me, but I did wonder if I might be shunning an effective treatment. I’m clearly not. I’ll stick with my Premarin cream that has been studied and is effective. Seriously, it gave me my back life.
If you want to make your mind explode a little (not in a good way) check out the many ‘summits’ offered through DrTalks. I was getting advertisements for about one of these a week, many targeting ‘women’s issues.’ I learned it’s primarily supplements, bioidentical hormones, and unproven technologies/treatments (like laser), brought to you by the people who invented/sell/offer them. So basically it’s like a 2-5 day infomercial in interview format. Quite slick, and meant to look like it’s all safe and effective—I mean, it’s all doctors, right? That are talking? The tone I got was that safe and proven treatments are ‘old fashioned.’ Premarin is laughed at because ‘it’s from pregnant mares!’ and so could only be inferior to a bioidentical product. It’s an interesting way to market, I suppose.
I’m wondering if you looked into Thermiva at all (not a laser). My gyno said she was getting good results for dryness for ppl for whom hrt is not enough.
The data for the radiofrequency devices like Thermiva is even worse. it's also not clear how it could actually work!