The efficacy of fractional CO2 laser (FemiLift™) treatment in postmenopausal females with vulvovaginal atrophy: Preliminary results from a single center in Turkey
Abstract
Objective: Symptoms, such as vaginal laxity, dryness, dyspareunia, itching, burning, and urine leakage, associated with vulvovaginal atrophy (VVA) with hypo-osteogenesis etiology, are frequently seen in postmenopausal females, and they diminish quality of life. This study aimed to evaluate the efficacy of CO2 laser treatment in these cases and to evaluate the potential side-effects related to this type of treatment.
Materials and Methods: A retrospective examination was made of the clinical examination and treatment records of 30 patients, aged 48–72 years, who presented with VVA complaints and underwent CO2 laser treatment for a total of three sessions at intervals of 4–6 weeks. The VVA symptoms of all the patients were evaluated using a Visual Analog Scale (VAS) before the first laser session and 4 weeks after the final session.
Results: The VVA symptoms of dryness, painful sexual relations, vaginal burning, itching, and vaginal introitus pain were evaluated with VAS scores; a statistically significant reduction was determined in all five symptoms after CO2 laser treatment.
Conclusion: A significant reduction was obtained in the VVA complaints with no significant side-effects following the application of CO2 laser treatment for VVA cases in the postmenopausal females. Thus, this treatment can be considered to a reliable alternative for patients who do not wish to use local estrogen creams long-term, those with a history of breast or gynecological cancer, and those with contra-indications for the use of local estrogen.
Keywords
Vulvovaginal atrophy , CO2 laser treatment , Hypo-oestrogenemia , Postmenopausal females
References
- 1. Mac Bride MB, Rhodes DJ, Shuster LT. Vulvovaginal atrophy. Mayo Clin Proc 2010;85(1):87-94.
- 2. Nappi RE, Kokot-Kierepa M. Vaginal health: insights, views & attitudes (VIVA) results from an international survey. Climacteric 2012;15(1):36-44.
- 3. Nappi RE, Lachowsky M. Menopause and sexuality: prevalence of symptoms and impact on quality of life. Maturitas 2009;63(2):138-141.
- 4. Yoo C, Yun MR, Ahn J-H, Jung KH, Kim HJ, Kim JE, et al. Chemotherapy-induced amenorrhea, menopause-specific quality of life, and endocrine profiles in premenopausal women with breast cancer who received adjuvant anthracycline-based chemotherapy: a prospective cohort study. Cancer Chemother Pharmacol 2013;72(3):565–575.
- 5. Santen RJ. Vaginal administration of estradiol: effects of dose, preparation and timing on plasma estradiol levels. Climacteric 2015;18(2):121-134.
- 6. Kaufmann R, Hibst R. Pulsed Erbium:YAG laser ablation in cutaneous surgery. Lasers Surg Med. 1996;19(3):324-330.
- 7. Prignano F, Campolmi P, Bonan P, Ricceri, F, Cannarozzo G, Troiano M, et al. Fractional CO2 laser: a novel therapeutic device upon photobiomodulation of tissue remodeling and cytokine pathway of tissue repair. Dermatol Ther 2009;22 Suppl 1: S8-15.
- 8. Salvatore S, Leone Roberti Maggiore U, Origoni, M, Candiani M, Calligaro A, et al. Histological study on the effects of microablative fractional CO2 laser on atrophic vaginal tissue: an ex vivo study. Menopause 2015;22(8):845-849.
- 9. Portman DJ, Gass ML, Vulvovaginal Atrophy Terminology Consensus Conference P. 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. Climacteric 2014;17(5):557–563.
- 10. Tadir Y, Gaspar A, Lev-Sagie A, Alexiades M, Alinsod R, BaderA, et al. Light and energy based therapeutics for genitourinary syndrome of menopause: consensus and controversies. Lasers Surg Med 2017;49(2):137–159.