Skip to main content

Advertisement

Log in

Evaluation of the efficacy of fractional CO2 laser in the treatment of vulvar and vaginal menopausal symptoms

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

A Correction to this article was published on 07 January 2021

This article has been updated

Abstract

Purpose

The objective of this study was to evaluate the efficacy of fractional CO2 laser to manage vulvar and vaginal symptoms of Genitourinary Syndrome of Menopause (GSM) in postmenopausal women.

Methods

All postmenopausal women with symptoms of GSM undergoing fractional CO2 laser treatment in our centers were asked to fill out a validated quality of life questionnaire (Global Quality of Life Questionnaire), Visual Analog Scale (VAS) for symptoms, a questionnaire on overall discomfort related to pelvic floor symptoms, and the Female Sexual Function Index (FSFI) at several points: before each session (three sessions at monthly intervals) and one 3 months after treatment completion. Statistical analysis compared pre-therapy data and data at 3 months of treatment.

Results

Forty-six women were included with a mean age of 57.3 years (± 11.1 years). A significant improvement was demonstrated in vaginal dryness (p = 6.34 10–6) and for symptoms of stress urinary incontinence (p = 0.043). Among sexually active patients, there was a significant improvement in the degree of symptom discomfort affecting their satisfaction (p = 0.007), dyspareunia (p = 0.001) and sensitivity during sexual intercourse (p = 0.001). Significantly, more women were able to achieve (p = 0.026) and maintain (p = 0.018) lubrication during intercourse.

Conclusion

CO2 laser treatment seems to improve the quality of life and sexual health of patients as well as GSM symptoms at 3 months of treatment; long-term reevaluation is necessary to demonstrate that improvement persists over time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Change history

References

  1. Portman DJ, Gass MLS, Vulvovaginal Atrophy Terminology Consensus Conference Panel (2014) Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and the North American Menopause Society. Maturitas. 79(3):349–354

    Article  CAS  Google Scholar 

  2. Nappi RE, Palacios S (2014) Impact of vulvovaginal atrophy on sexual health and quality of life at postmenopause. Climact J Int Menopause Soc 17(1):3–9

    Article  CAS  Google Scholar 

  3. Wysocki S, Kingsberg S, Krychman M (2014) Management of vaginal atrophy: implications from the REVIVE survey. Clin Med Insights Reprod Health 8:23–30

    Article  Google Scholar 

  4. North American Menopause Society (2013) Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause 20(9):888–902

    Article  Google Scholar 

  5. Palacios S, Castelo-Branco C, Currie H, Mijatovic V, Nappi RE, Simon J et al (2015) Update on management of genitourinary syndrome of menopause: a practical guide. Maturitas 82(3):308–313

    Article  Google Scholar 

  6. Mendoza N, Abad P, Baró F, Cancelo MJ, Llaneza P, Manubens M et al (2013) Spanish Menopause Society position statement: use of tibolone in postmenopausal women. Menopause 20(7):754–760

    Article  Google Scholar 

  7. Lethaby A, Ayeleke RO, Roberts H (2016) Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev 8:CD001500

    Google Scholar 

  8. Cardozo L, Bachmann G, McClish D, Fonda D, Birgerson L (1998) Meta-analysis of estrogen therapy in the management of urogenital atrophy in postmenopausal women: second report of the Hormones and Urogenital Therapy Committee. Obstet Gynecol 92(4 Pt 2):722–727

    CAS  PubMed  Google Scholar 

  9. Kingsberg SA, Krychman M, Graham S, Bernick B, Mirkin S (2017) The Women’s EMPOWER survey: identifying women’s perceptions on vulvar and vaginal atrophy and its treatment. J Sex Med 14(3):413–424

    Article  Google Scholar 

  10. Tadir Y, Gaspar A, Lev-Sagie A, Alexiades M, Alinsod R, Bader A et al (2017) Light and energy based therapeutics for genitourinary syndrome of menopause: consensus and controversies. Lasers Surg Med 49(2):137–159

    Article  Google Scholar 

  11. Athanasiou S, Pitsouni E, Antonopoulou S, Zacharakis D, Salvatore S, Falagas ME et al (2016) The effect of microablative fractional CO2 laser on vaginal flora of postmenopausal women. Climact J Int Menopause Soc 19(5):512–518

    Article  CAS  Google Scholar 

  12. Behnia-Willison F, Sarraf S, Miller J, Mohamadi B, Care AS, Lam A et al (2017) Safety and long-term efficacy of fractional CO2 laser treatment in women suffering from genitourinary syndrome of menopause. Eur J Obstet Gynecol Reprod Biol 213:39–44

    Article  Google Scholar 

  13. Ware J, Kosinski M, Keller SD (1996) A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233

    Article  Google Scholar 

  14. de Tayrac R, Deval B, Fernandez H, Marès P (2008) Validation linguistique en français des versions courtes des questionnaires de symptômes (PFDI-20) et de qualité de vie (PFIQ-7) chez les patientes présentant un trouble de la statique pelvienne. J Gynécol Obstét Biol Reprod 36(8):738–748

    Article  Google Scholar 

  15. Rosen R, Brown C, Heiman J, Leiblum S, Meston C, Shabsigh R et al (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26(2):191–208

    Article  CAS  Google Scholar 

  16. Jardin I, Louis-Vahdat C, Canlorbe G, Mergui J-L, Uzan C, Azaïs H (2018) How I do? A treatment with fractional CO2 LASER for vulvovaginal atrophy symptoms in menopausal women. Gynecol Obstet Fertil Senol 46(10–11):735–739

    CAS  PubMed  Google Scholar 

  17. Paraiso MFR, Ferrando CA, Sokol ER, Rardin CR, Matthews CA, Karram MM et al (2019) A randomized clinical trial comparing vaginal laser therapy to vaginal estrogen therapy in women with genitourinary syndrome of menopause: the VeLVET Trial. Menopause 27:50–56

    Article  Google Scholar 

  18. Politano CA, Costa-Paiva L, Aguiar LB, Machado HC, Baccaro LF (2019) Fractional CO2 laser versus promestriene and lubricant in genitourinary syndrome of menopause: a randomized clinical trial. Menopause 26(8):833–840

    Article  Google Scholar 

  19. González Isaza P, Jaguszewska K, Cardona JL, Lukaszuk M (2018) Long-term effect of thermoablative fractional CO2 laser treatment as a novel approach to urinary incontinence management in women with genitourinary syndrome of menopause. Int Urogynecology J 29(2):211–215

    Article  Google Scholar 

  20. Sipos AG, Kozma B, Poka R, Larson K, Takacs P (2019) The effect of fractional CO2 laser treatment on the symptoms of pelvic floor dysfunctions: pelvic floor distress inventory-20 Questionnaire. Lasers Surg Med 51:882–886

    Article  Google Scholar 

  21. FDA (2018) Health C for D and R. FDA Warns Against Use of Energy-Based Devices to Perform Vaginal ‘Rejuvenation’ or Vaginal Cosmetic Procedures: FDA Safety Communication. FDA, Washington

    Google Scholar 

  22. Sokol ER, Karram MM (2016) An assessment of the safety and efficacy of a fractional CO2 laser system for the treatment of vulvovaginal atrophy. Menopause 23(10):1102–1107

    Article  Google Scholar 

  23. Madelenat P (2019) When an editorial becomes a subject of real debate. Gynecol Obstet Fertil Senol 47(9):689

    CAS  PubMed  Google Scholar 

  24. Deval B, Swift S, Mourad S, Hayward L, Digesu A (2019) Application of laser in uro-gynecology: warning! Gynecol Obstet Fertil Senol 47(9):690–691

    CAS  PubMed  Google Scholar 

  25. Mares P (2019) Emerging techniques in uro-gynecology: a new deal. Gynecol Obstet Fertil Senol 47(9):696–697

    CAS  PubMed  Google Scholar 

  26. Deffieux X (2019) Vaginal laser in pelviperineology: fears and facts. Gynecol Obstet Fertil Senol 47(9):694–695

    CAS  PubMed  Google Scholar 

  27. Azaïs H (2019) Vaginal LASER therapy, a pragmatic option for patients after cancer. Gynecol Obstet Fertil Senol 47(9):692–693

    PubMed  Google Scholar 

  28. Athanasiou S, Pitsouni E, Douskos A, Salvatore S, Loutradis D, Grigoriadis T (2020) Intravaginal energy-based devices and sexual health of female cancer survivors: a systematic review and meta-analysis. Lasers Med Sci. 35(1):1–11

    Article  Google Scholar 

  29. Millheiser LS, Pauls RN, Herbst SJ, Chen BH (2010) Radiofrequency treatment of vaginal laxity after vaginal delivery: nonsurgical vaginal tightening. J Sex Med 7(9):3088–3095

    Article  Google Scholar 

  30. Kamilos MF, Borrelli CL (2017) New therapeutic option in genitourinary syndrome of menopause: pilot study using microablative fractional radiofrequency. Einstein 15(4):445–451

    Article  Google Scholar 

Download references

Funding

This study had no funding.

Author information

Authors and Affiliations

Authors

Contributions

HA contributed to conceptualization and idea and methodology. TSF and CLV helped with literature search and data analysis. TSF and HA contributed to writing—original draft preparation. GC, JLM and EOEC helped with writing—review and editing. CU, GC and HA contributed to supervision.

Corresponding author

Correspondence to H. Azaïs.

Ethics declarations

Conflict of interest

T. Sindou-Faurie declares that she has no conflict of interest. C. Louis-Vahdat declares that she has no conflict of interest. E. Oueld Es Cheikh declares that she has no conflict of interest. G. Canlorbe declares that he has no conflict of interest. JL. Mergui declares that he has no conflict of interest. C. Uzan declares that she has no conflict of interest. H. Azaïs declares that he has no conflict of interest. All procedures performed in studies involving human participants were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sindou-Faurie, T., Louis-Vahdat, C., Oueld Es Cheikh, E. et al. Evaluation of the efficacy of fractional CO2 laser in the treatment of vulvar and vaginal menopausal symptoms. Arch Gynecol Obstet 303, 955–963 (2021). https://doi.org/10.1007/s00404-020-05868-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-020-05868-w

Keywords

Navigation