Reading the latest New York Times article about sex trends, as one does, I discovered that some lubes are now contained in bottles so luxe and beautiful that they just might rival a bottle of Chanel No. 5.

I hovered over the Add to Cart button: one bottle for $55, or two for $90? Given my age—sixtysomething—I might not have enough time left to empty both of them, but at least they’ll look pretty next to my deathbed.

And then I thought, not for the first time, about getting “the Mona Lisa.”

Developed in Italy in 2012 (hence the name, or perhaps it’s because it leaves patients smiling enigmatically?), the MonaLisa Touch is touted by the company as “a unique vaginal probe to deliver gentle, fractional CO₂ laser energy to the vaginal wall tissue.” This can regenerate collagen in the membrane lining of the vaginal wall, releasing more moisture. (May God strike me down for using that word.) It can also treat mild urinary incontinence by strengthening the pelvic floor.

In other words, this CO₂ laser, and similar ones from other manufacturers, including the FemiLift and the CO2RE Intima, do what CO₂ lasers do to your face: They hurt to heal. No one likes to use the word “wound,” but that’s exactly what it delivers, even though it’s performed by a licensed gynecologist. The recommended protocol consists of three treatments lasting five minutes or less, performed in intervals over several months, each ranging from around $500 to $700 a pop—depending on Zip Code—with subsequent visits recommended annually.

“Imagine readying a chicken for rotisserie cooking, only I was the chicken,” wrote writer and actress Annabelle Gurwitch. She described her own experience with the MonaLisa Touch in her memoir You’re Leaving When? Adventures in Downward Mobility. “When the laser was applied to my labia, it had that same prickliness of swiping your scalp with a curling iron,” she wrote.

Has 300 seconds ever felt so long? “The outer edges [of the vagina] were on fire, and the inside was pulsating,” she wrote. “It was practically humming with energy and might have been visibly glowing through my jeans.” She left the clinic holding an ice pack to her crotch, but here’s the kicker: the treatment allowed Gurwitch to have sex comfortably for the first time in years.

“I hate having to scorch my vagina for its own good,” says Sylvie, 50, a performance artist in Brooklyn. (Most laser users preferred to remain anonymous, so Air Mail is using pseudonyms.) “But I was having such trouble, I couldn’t even get a dilator in there—it felt like it was made of old parchment. I could practically hear it crinkling.”

The first session was excruciating; Sylvie describes the burning sensation as “extreme.” The pain, she says, lasted 16 hours. “But then it completely healed the problem. I got my vagina back.”

The MonaLisa Touch is F.D.A.-approved for use in general and plastic surgery, and dermatology in the U.S.—but its effectiveness hasn’t been evaluated yet for vaginal rejuvenation. It was approved for licensed gynecologists to treat genital warts, as well as abnormal and pre-cancerous vaginal and cervical tissue. In 2018, the F.D.A. issued a warning that enlisting the device for purposes of “rejuvenation” has unknown risks, and that instances of burns, scarring, and other pain had been reported.

“I hate having to scorch my vagina for its own good.”

Still, some providers use the procedure off-label. Because let’s face it: a post-menopausal woman’s anxieties about reaching her sell-by date do not end with the skin on her face.

Even when the treatment is technically successful, it can come with side effects. Another source, whom we are calling “Elsa,” 63, has endured severe vaginal atrophy for years. “This goes way beyond sex,” she says. “Even running is uncomfortable. There are not many hours of the day when I’m not thinking about how my vagina is feeling.”

She had tried topical estrogen, but it caused cramping, so she ventured into the VSpot, in Manhattan, which touts its “curated” aesthetic team for all things vagina. (Its existence is definitely not, as one friend suggested, a harbinger of end times.) “It was extremely painful, but that wasn’t even the main problem,” says Elsa of the MonaLisa. “My pelvic-floor muscles went into these spasms I’ve never experienced before. It was like this intense quivering, kind of like a charley horse, that went on and on all night. The next day, I went to my gynecologist, and she looked at me very seriously and said, ‘Do not ever do that again.’”

“But even after one treatment, I noticed a difference,” says Elsa. The vaginal tissue did seem to be “plump and fluffy,” as one happy patient described. “But I couldn’t possibly go back and do that again,” Elsa adds. (When Elsa wondered why this service was offered by so many practitioners, her doctor simply said, “Some people just need another revenue stream.”)

Dr. Melanie Marin is the director of the Menopause Program at the Mount Sinai hospital. About five years ago, her department spent around $160,000 on the MonaLisa Touch. After five years, the machine hasn’t paid for itself, and Marin is fine with that. “The laser is not the first line of treatment—the first line is vaginal estrogen,” explains Marin. (Numerous studies have established that vaginal estrogen does not change the rate of cancer, but, nevertheless, some women don’t want to use it.) “Also, I really take issue with the term ‘vaginal rejuvenation,’ and the suggestion that every woman should be adding this treatment to their beauty arsenal,” she continues. “Some people age and have no problem with sex, elasticity, dryness, their urinary tract. Some people do.”

It’s not like we’re the only culture at war with our cooches. A 2005–6 study of vaginal practices in Indonesia, Mozambique, South Africa, and Thailand demonstrated that each society had reasons—health-related, cosmetic, sexual, and, well, the word “supernatural” was thrown around—to turn their vaginas into self-improvement projects, often by using a potpourri of local herbs.

In many instances, the objective was to augment men’s pleasure. O.K., sure. But I suspect that some of these women may have been reluctant to say the quiet part out loud: these efforts are primarily for our benefit—a way to enhance the pleasures of both receiving and giving. (Basically, when it comes to the vagina, most straight men are just happy to be around one.)

Still, is there any time in our life when we can stop worrying about this stuff? When I talked to women about their experiences, I had flashbacks to America Ferrera’s speech in the new film Barbie—we’re all fretting about being too much, or too little.

According to Marin, about 90 percent of her patients do not find the laser treatment overly painful and are very happy with the results. And then there’s a special subset who find it painful and still keep going back. “Oh, I scream like a baby when I have it done,” says Laura, a prominent film executive. “But I still go back for tune-ups once a year. It only lasts a couple of minutes, and do you know what’s a lot worse than this? Painful sex. Which I don’t have anymore.”

Judith Newman is a New York–based writer and the author of To Siri with Love