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Meet Consultant Gynaecologist Pandelis Athanasias

The menopause is a normal, natural part of life, but many women feel too embarrassed to talk about the ways in which it affects them. More than half of women will experience vaginal atrophy (thinning and drying of the vaginal walls) at some point in their lives, and very often they think nothing can be done to help when vaginal moisturisers and lubricants fail to treat the symptoms. Thankfully, there are many ways to treat vaginal atrophy.

We caught up with Consultant Gynaecologist Mr Pandelis Athanasias, to talk about the menopause, how MonaLisa Touch Laser Treatment can help certain menopausal symptoms, and why many women who’ve had the treatment say it’s changed their lives.  



Who comes to see you?

The gynaecology team here at the clinic see women with a broad spectrum of conditions. My expertise includes minimally invasive treatments for heavy vaginal bleeding, ovarian cysts, endometriosis and investigations and treatments for abnormal smears and menopausal symptoms.


How do you treat menopausal conditions and symptoms?

The menopause can affect almost every system in a woman’s body, and I believe in a  holistic approach. I incorporate treatments using different types of HRT. I also prescribe bioidentical hormones and I offer treatments for vaginal atrophy, such as the MonaLisa Touch Laser Treatment. I also work and liaise with nutritionists and physiotherapists with advanced knowledge and expertise in gynaecological issues.


When did you come across MLT?

When I was in the US a few years ago. I met and talked with the clinicians who introduced the laser treatment and supervised most of the research. Then I travelled to Milan and  talked to patients with vaginal atrophy who’d had MLT treatments in the past. The huge satisfaction rate and improvement in their quality of life convinced me to introduce the treatment to my patients in London.


What’s the typical age of women you treat?

So far I’ve treated women in various age groups – including breast cancer survivors who typically enter the menopause early. I’ve also seen women in their seventies and eighties. The vast majority of these patients have seen a massive improvement in their conditions, including vaginal soreness and recurrent urinary tract infections (UTIs).  


So the treatment has proved life-changing?

It was remarkable that these women had previously believed that there was no treatment for their condition. They had already tried vaginal moisturisers, lubricants and topical oestrogen when it was not contraindicated. They’d almost decided that they’d just have to live with it. But they were amazed with MonaLisa Touch.

I’ve had patients who’ve found vaginal atrophy debilitating. They couldn’t have a normal lifestyle and they couldn’t have sexual intercourse for years. Many couldn’t exercise or even go for a long walk because of vaginal burning and soreness. Seeing symptoms dramatically improve was really encouraging. I was so glad to see women’s lives gradually going back to normal.  


What about women who don’t know about MonaLisa Touch?

So many of the patients I’ve treated want to talk about how the treatment has worked for them. That’s because they know there might be many women who are living with conditions such as vaginal atrophy, who might not be aware of the treatment.


How does the MonaLisa Touch Laser treatment work?

It uses a CO2 laser that affects the vaginal lining. It causes inflammation and subsequently  thickening and regeneration of the tissues.

I’m a big supporter and advocate of MLT as there are many scientific studies on it in reputable medical journals. They’ve looked at every aspect of the treatment. It is extremely important that every new and cutting edge treatment be supported by scientific evidence that supports the effectiveness and safety.


And what would a patient coming to you for the treatment expect?

I need to know what I’m treating. That’s why the treatment should preferably be done by a gynaecologist or an expert in vaginal health. I take a detailed history and then perform an examination to ascertain whether it’s atrophy that’s causing the symptoms.

If I feel that MonaLisa Touch is the right choice, I always agree to do the first treatment there and then. Unless, of course, the patient wants time to think.

The probe is inserted into the vagina after application of local anaesthetic gel.

Then it is gradually removed from the vagina.


Is it painful? And what’s the recovery time?

The treatment is painless and takes between 5-10 minutes. Also, the recovery is immediate.


How often should a patient have the treatments?

We usually suggest three treatments a year at 4-6 weekly intervals, and then one maintenance treatment every year. Of course, everyone is different, so that’s why a patient should only be treated by an expert in vaginal health. That way, they get a treatment plan tailored to their needs.

Sometimes I’ve had patients who’ve had severe atrophy and needed more treatments. Or they might need to take medication – in the form of oestrogen cream or tablets if a patient doesn’t have any contraindications – to maintain the outcome of the treatment and prolong the intervals between the maintenance laser treatments.

If a patient’s symptoms return earlier, I will assess her situation to decide whether we need to bring the maintenance treatments forward.


Are there any adverse effects you’ve been aware of?

Not with the women I’ve treated. I’ve heard of situations where the patient already had a vaginal infection, but this is a contraindication for performing the treatment. That’s why it’s so important that the treatment is carried out by a gynaecologist.


So it’s important to carefully assess every patient?

Absolutely. Careful assessment and selection of the patients who need the treatment is vital. It’s not a case of offering the treatment to anyone who wants it. We have to ascertain whether this is the right treatment and consider all the treatment options. I will always be honest with my patients if I don’t think they are suitable for this treatment.

For example, It could that it’s not atrophy causing the symptoms. Or, if the atrophy is mild and they haven’t tried any less-invasive treatments, that’s what I’d suggest first. I’d initiate those treatments, and we’d chat at a later stage to see if they need MLT.


Do you work with other specialists such as nutritionists?

Yes I do, because any hormonal condition such as the menopause, endometriosis or PMS can be affected by the things somebody eats or drinks. I work with a nutritionist who has expertise in hormonal-gynaecological conditions. Also, for conditions such as stress incontinence that involve the pelvic floor, I work with women’s health physiotherapists.

We’ll look at the pathology from different angles so we can provide the best treatment plan.  


The lowdown on MonaLisa Touch:

How much? £650 per treatment.

How long? 5-10 minutes for the treatment.

How many treatments per year? We advise three treatments at 4-6 weekly intervals, plus a yearly maintenance treatment.

Recovery time? None.

MonaLisa Touch treatments are always carried out by a Consultant Gynaecologist. If you’d like to learn more or make an appointment, please contact our clinic.