Patient-reported sexual function of breast cancer survivors with genitourinary syndrome of menopause after fractional CO2 laser therapy

Abstract

Objective: The objective of this pilot study was to evaluate the change in sexual function following treatment with fractional CO2 laser therapy in breast cancer (BC) survivors with genitourinary syndrome of menopause (GSM). Methods: A single-arm feasibility study of BC survivors with symptoms of GSM, including dyspareunia and/or vaginal dryness, was conducted. Participants who received three treatments with fractional CO2 laser and 4-week follow-up were contacted for patient-reported outcomes and adverse events at 12 months. Sexual function was measured using the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale Revised (FSDS-R). Descriptive statistics were calculated for patient demographics and disease characteristics for the set of participants who agreed to long-term follow-up and those who were lost to follow-up. FSFI and FSDS-R scores were summarized at baseline, 4 weeks and 12 months, as well as the change from baseline, and were compared using a Wilcoxon signed rank test. Results: A total of 67 BC survivors enrolled, 59 completed treatments and 4-week follow-up; 39 participated in the 12 month follow-up. The overall FSFI score improved from baseline to 4-week follow-up (median Δ 8.8 [Q1, Q3] (QS) (2.2, 16.7)], P < 0.001). There were improvements at 4 weeks in all domains of the FSFI (P < 0.001 for each) including desire (median Δ 1.2; QS [0.6, 1.8]), arousal (median Δ 1.2; QS [0.3, 2.7]), lubrication (median Δ 1.8 (0, 3.3), orgasm (median Δ 1.2; QS [0, 3.6]), satisfaction (median Δ 1.6 (0.4, 3.2)), and pain (median Δ 1.6 (0, 3.6). The FSDS-R score also improved from baseline to 4-week follow-up (median Δ −10.0; QS [−16, −5] P < 0.001) indicating less sexually related distress. The scores of the FSFI and FSDS-R remained improved at 12 months and there were no serious adverse events reported. Conclusions: In BC survivors with GSM, the total and individual domain scores of the FSFI and the FSDS-R improved after fractional CO2 laser therapy. Video Summary: http://links.lww.com/MENO/A711.

Effects of local laser treatment on vulvovaginal atrophy among women with breast cancer: a prospective study with long-term follow-up

“…Our results are similar to those of a recent cohort study in BC women treated with CO 2 laser therapy, where FSFI score improved in the same magnitude, and with changes remaining 12 months after laser therapy [28]. Of note, three randomized studies [29][30][31] comparing laser therapy versus local hormonal therapy or a combination of both in postmenopausal women without breast cancer revealed that laser therapy and local hormonal therapy had similar efficacy on VVA symptoms, with improvement of FSFI scores in all of them.…”

Long-Term Follow-Up of Fractional CO2 Laser Therapy for Genitourinary Syndrome of Menopause in Breast Cancer Survivors

“…This study protocol was amended to collect follow-up data at one and two years to augment the limited long-term data on this treatment. Patient-reported sexual function was collected at one-year and demonstrated improvement in the FSFI and FSDS-R scores [26]. Here, we report the two-year follow-up results.…”

“…Fractional CO 2 laser treatment has also been used in women with cancer, most commonly breast cancer. Data based on retrospective [21][22][23] and several small single-arm studies have shown improvement in vaginal symptoms and sexual function [24][25][26][27][28]. A major limitation of these studies has been a lack of long-term follow-up to evaluate persistence of benefit of this intervention.…”

Genitourinary Syndrome of Menopause

“…42 Of the 64 participants, 59 women completed the study, and at the 4-week follow-up, all had an improvement in their sexual function scores measured by the Female Sexual Function Index and the Female Sexual Distress Scale Revised. 42 Thirty-nine women completed the 12-month follow-up and reported no adverse effects. 42…”

“…Finally, a pilot study that evaluated sexual function of breast cancer survivors with GSM symptoms enrolled 64 participants to receive 3 CO 2 laser treatments 42 . Of the 64 participants, 59 women completed the study, and at the 4‐week follow‐up, all had an improvement in their sexual function scores measured by the Female Sexual Function Index and the Female Sexual Distress Scale Revised 42 . Thirty‐nine women completed the 12‐month follow‐up and reported no adverse effects 42 …”