Laser therapy as a treatment modality for genitourinary syndrome of menopause: a critical appraisal of evidence.

Interest in laser therapy as a nonhormonal option for the treatment of genitourinary syndrome of menopause (GSM) has increased. We conducted a systematic review of the use of laser therapy for the relief of GSM symptoms. Six electronic databases were searched and conference abstracts were searched manually from the introduction of laser therapy to the present date. The keywords used were: "genitourinary syndrome", "vulvovaginal atrophy", "postmenopausal symptoms", "laser therapy" and "fractional laser treatment". Of the 165 articles identified in the search, none was a randomized controlled trial. As a result, we included three observational studies without a control group and one case-control study that met our inclusion criteria. The total number of women included in the four studies was 220. The collated data suggest that laser therapy may be valuable as a nonhormonal therapeutic modality in the management of GSM. Higher quality of evidence from randomized controlled trials is required to establish the efficacy of laser treatment in the management of GSM.