Stavros Athanasiou1, Eleni Pitsouni2, Matthew E Falagas3, Stefano Salvatore4, Themos Grigoriadis2. 1. Urogynaecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Greece. Electronic address: stavros.athanasiou@gmail.com. 2. Urogynaecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Greece. 3. Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece; Department of Medicine-Infectious Diseases, Iaso General Hospital, Athens, Greece; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA. 4. Urogynecology Unit, Obstetrics and Gynecology Unit, Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy.
Abstract
OBJECTIVES: The aim of this prospective study was to assess the efficacy of 3, 4 or 5 CO2-laser sessions for the management of the genitourinary syndrome of menopause (GSM). METHODS: Postmenopausal women with moderate to severe symptoms of dyspareunia, wanting to resume/retain sexual activity, were treated with 3-5 laser sessions depending on symptom severity/presence, sexual function, clinical findings and women's preference following the third laser application. MAIN OUTCOMES: Severity of dyspareunia, dryness, sexual function, sexual satisfaction and frequency of sexual intercourse defined the primary outcomes. Vaginal Maturation Value (VMV) and Vaginal Health Index Score (VHIS) defined the secondary ones. RESULTS: Fifty-five women received three sessions, 53 an extra fourth and 22 an extra fifth. Following the third, fourth and fifth laser sessions, respectively: dyspareunia completely regressed in 15/55 (27%), 32/55 (58%) and 38/47 (81%) of participants; dryness completely regressed in 20/55 (36%), 36/55 (66%) and 44/51 (86%); normal sexual function resumed in 23/55 (41%), 37/54 (69%) and 41/49 (84%); VMV regained non-atrophic values in 29/55 (53%), 38/55 (69%) and 42/50 (84%); and VHIS regained non-atrophic values in 44/55 (80%), 53/55 (96%) and 55/55 (100%) of participants. CONCLUSION: Results of this study indicate that CO2-laser therapy may contribute to complete regression of dyspareunia and dryness and reestablishment of normal sexual function in postmenopausal women, in a dose-response manner. An extra fourth or fifth session may further increase the GSM symptom-free rate.
OBJECTIVES: The aim of this prospective study was to assess the efficacy of 3, 4 or 5 CO2-laser sessions for the management of the genitourinary syndrome of menopause (GSM). METHODS: Postmenopausal women with moderate to severe symptoms of dyspareunia, wanting to resume/retain sexual activity, were treated with 3-5 laser sessions depending on symptom severity/presence, sexual function, clinical findings and women's preference following the third laser application. MAIN OUTCOMES: Severity of dyspareunia, dryness, sexual function, sexual satisfaction and frequency of sexual intercourse defined the primary outcomes. Vaginal Maturation Value (VMV) and Vaginal Health Index Score (VHIS) defined the secondary ones. RESULTS: Fifty-five women received three sessions, 53 an extra fourth and 22 an extra fifth. Following the third, fourth and fifth laser sessions, respectively: dyspareunia completely regressed in 15/55 (27%), 32/55 (58%) and 38/47 (81%) of participants; dryness completely regressed in 20/55 (36%), 36/55 (66%) and 44/51 (86%); normal sexual function resumed in 23/55 (41%), 37/54 (69%) and 41/49 (84%); VMV regained non-atrophic values in 29/55 (53%), 38/55 (69%) and 42/50 (84%); and VHIS regained non-atrophic values in 44/55 (80%), 53/55 (96%) and 55/55 (100%) of participants. CONCLUSION: Results of this study indicate that CO2-laser therapy may contribute to complete regression of dyspareunia and dryness and reestablishment of normal sexual function in postmenopausal women, in a dose-response manner. An extra fourth or fifth session may further increase the GSM symptom-free rate.
Keywords:
Atrophy; Female Sexual Function Index (FSFI); Genitourinary syndrome of menopause (GSM); Menopause; Sexual dysfunction; Vulvovaginal atrophy (VVA)