Two women can walk into the same consultation describing the same thing and leave with completely different recommendations. One gets a laser. The other gets radiofrequency. Neither is wrong.
That is because MonaLisa Touch vs Votiva comes down to the type of concern being treated, even though both fall under vaginal rejuvenation. At Entice Intimate Wellness + Aesthetics in Dallas, Shelley Hoffmann, PA, and our experienced all-female clinical team perform consultations and treatments, and the first appointment is exactly where we determine which treatment fits.
The choice becomes much clearer once you separate the symptoms each treatment is designed to address.
Key Takeaways
- MonaLisa Touch uses fractional CO2 laser energy. Votiva uses bipolar radiofrequency.
- Dryness, burning, and painful intercourse point toward MonaLisa Touch, which also works without hormones.
- Laxity, mild leaking, and external tone point toward Votiva, the only one of the two that treats external tissue.
- Neither affects the pelvic floor muscles, and neither is permanent.
- A consultation helps determine whether MonaLisa Touch, Votiva, a combination of both, or another treatment best fits your concerns.
Start With Your Symptom, Not the Technology
The question is simple: what would you most want to change? Answer that, and the treatment choice usually follows on its own.
If it is dryness, burning, or pain during sex
MonaLisa Touch. It uses fractional CO2 laser energy to rebuild collagen and improve blood flow in the vaginal wall, restoring moisture and tissue thickness at the source rather than masking the symptom.
It also does this without hormones, which matters enormously for breast cancer survivors and anyone else avoiding estrogen. Nothing is added. The tissue rebuilds itself. That hormone-free approach is why many women turn to MonaLisa Touch during menopause.
If it is looseness or reduced sensation
Votiva. Bipolar radiofrequency warms the tissue evenly, prompting collagen and elastin production that firms and tightens what is already there.
If it is leaking when you cough, laugh, or exercise
Votiva, with a caveat worth reading below. It improves bladder support by tightening the surrounding tissue, which helps with mild incontinence.
If it is how the external area looks
Votiva, specifically the FractoraV applicator. MonaLisa Touch treats internally. Votiva has an external applicator that addresses labial tone and appearance, which is the only thing one of these two can do.
If it is more than one of the above
Both, potentially. They address different tissue properties, so combining them is not redundant.
What Neither Treatment Does
Votiva does not affect your pelvic floor muscles. It tightens tissue, not muscle. If your laxity is significant, tissue tightening alone will underdeliver, and surgical tightening may be the more honest recommendation.
MonaLisa Touch does not change structure. It restores tissue health. If your concern is how much tissue there is or where it sits, a laser will not resolve it.
Neither is permanent. Both maintain results with periodic treatment, and neither stops tissue from continuing to change with age and hormones.
If a provider tells you one of these will fix everything, find another provider.
How the Technologies Actually Differ
When comparing Votiva vs MonaLisa Touch, the key distinction isn’t which technology is more advanced, but how each delivers energy and which tissue concerns it addresses.
MonaLisa Touch delivers laser energy in controlled microbeams to the vaginal wall. Each beam creates a small area of stimulation that triggers a healing response, producing new collagen and improving blood supply. Energy delivery takes about 5 minutes.
Votiva warms tissue evenly, not in a pattern. Two applicators handle different areas. FormaV works internally on laxity, dryness, and sensation. FractoraV works externally on labial tone and appearance.
A laser stimulating in a pattern is better suited to rebuilding tissue quality. Radiofrequency heating an entire area evenly is better suited to firming and reaching external tissue.
Who Each Treatment Suits
MonaLisa Touch may be a good fit if you:
- Experience persistent dryness, burning, or itching
- Have pain during intercourse related to tissue thinning
- Are postmenopausal or postpartum
- Cannot or prefer not to use estrogen therapy
- Have a history of breast cancer
Votiva may be a good fit if you:
- Notice mild to moderate laxity or reduced sensation
- Deal with occasional leaking during activity
- Want to improve tone or appearance of the external tissue
- Are postpartum, perimenopausal, or menopausal
- Prefer a treatment most patients describe as warm and relaxing
Which One Do Most Women Start With?
Women who come in after menopause usually start with MonaLisa Touch, because dryness and discomfort are typically what brought them in, and those symptoms respond well to it.
Women who come in after childbirth more often start with Votiva, since laxity and mild leaking are the more common complaints in that group and radiofrequency addresses both.
Women dealing with several concerns at once, which is more common than either group expects, usually end up on a combined plan. Where you start depends on which symptom affects your daily life most, and on where you are in life, since needs shift between the 40s and 50s.
When Neither Is Appropriate
Votiva is not recommended with an abnormal Pap in the last 12 months, a history of cervical cancer, previous bladder sling surgery, metal implants including pacemakers, during pregnancy or nursing, while menstruating, or with active herpes lesions.
MonaLisa Touch has its own screening criteria. Both treatments require a recent normal Pap and vaginal exam beforehand, which is standard practice and protects you.
What the Appointments Feel Like
Neither requires anesthesia beyond topical numbing.
MonaLisa Touch runs 30 to 45 minutes total. Most women describe a mild warming sensation.
Votiva runs 30 to 60 minutes depending on the areas treated. Numbing cream and ultrasound gel go on first, and most women compare it to a warm stone massage.
Both let you return to normal activity immediately. Votiva requires avoiding sexual activity, tampons, swimming, hot tubs, and baths for 2 days. MonaLisa Touch requires a similar 48-hour pause after internal treatment, with longer restrictions if external tissue was treated.
How Long Results Take and How Long They Last
Votiva follows a protocol of 3 treatments spaced 4 to 6 weeks apart, then one maintenance session annually. Some women notice improvement within days, though peak results arrive 2 to 3 months after the final session and hold for 12 to 18 months.
MonaLisa Touch treatments are also spaced 4 to 6 weeks apart. Many women notice a difference after the first, with optimal results around 3 months after the series. Annual maintenance keeps things consistent.
Individual response varies, and no outcome is guaranteed.
Beyond These Two Options
MonaLisa Touch and Votiva are not the only vaginal rejuvenation treatments worth knowing about, and the right plan sometimes involves neither.
Morpheus8V uses radiofrequency microneedling to reach deeper than Votiva does, remodeling tissue at the structural level. If you are weighing those two specifically, find out whether Votiva vs Morpheus8V is right for you.
VTone uses electrical muscle stimulation to strengthen the pelvic floor, filling the gap Votiva leaves.
Patients with both tissue changes and pelvic floor weakness often benefit from combining them.
Cost and Insurance
Both are elective, so insurance does not cover them. Pricing depends on how many sessions your plan calls for and, for Votiva, whether you are treating internally, externally, or both. Because both require maintenance, consider the annual cost rather than one series.
Questions to Ask at Your Consultation
- Which of my symptoms will this address, and which will it not?
- Based on my anatomy, how many sessions should I expect?
- Would combining treatments produce a better result than either alone?
- What happens if I do not respond to the first series?
- Is surgical tightening a more appropriate option for what I am describing?
A provider offering both surgical and non-surgical options can answer that question more objectively.
Why Choose Entice Intimate Wellness + Aesthetics for Vaginal Rejuvenation?
Your recommendation depends partly on what a practice offers. A provider with one device will assess you against that device.
For women considering vaginal rejuvenation in Dallas, Entice offers MonaLisa Touch, Votiva, Morpheus8 V, VTone, and surgical options rather than relying on a single technology. That range means our recommendations reflect your anatomy, not our inventory. Our certified all-female team performs these treatments often enough to know how different patients respond, and there are real reasons an all-female clinical team changes the experience for intimate wellness patients.
Learn More About Vaginal Rejuvenation Options at Entice
You should not have to guess which treatment fits. A consultation covers what is actually changing, which technology addresses it, and what a realistic timeline looks like. If neither is right for your situation, you will hear that before anything is scheduled.
As a leading provider of MonaLisa Touch and Votiva for vaginal rejuvenation in Dallas, TX, Entice Intimate Wellness + Aesthetics serves patients throughout Dallas and surrounding areas, including University Park, Highland Park, Preston Hollow, and the greater Dallas-Fort Worth area. Call (214) 774-2025 to schedule an appointment.
