The Efficacy and Safety of CO₂ Laser Treatment for Sexual Function and Vaginal Laxity Improvement in Pre‐Menopausal Women

Abstract

Background and Objectives Vaginal laxity lacks standardized diagnosis and severity criteria. It is considered as a subjective complaint that reflects decreased sexual satisfaction due to vaginal loosening. Treatment modalities have included physiotherapy and plastic surgery. Recently, laser treatments have also gained popularity as a means of relieving gynecological complaints such as pelvic organ prolapse, stress urinary incontinence, and genitourinary syndrome of menopause. The aim of the current study was to evaluate the efficacy of CO2 laser treatment in women for whom a decrease in sexual sensation during intercourse and vaginal loosening were their primary complaints. Study Design/Materials and Methods For this prospective study, women with reported vaginal laxity and decreased sensation during intercourse were recruited from the Sexual Dysfunction Clinic in our health care campus. Each participant received three outpatient treatments with laser therapy, according to the same protocol. Treatment efficacy was assessed by changes in the Vaginal Health Index (VHI) and Female Sexual Function Index (FSFI). Results Overall, 84 pre‐menopause women, with a mean age of 47.7 years, were included in the study. Mean VHI and FSFI were increased significantly at 3 months post‐treatment and decreased again at 6 months post‐treatment: 11.8 ± 1.6, 13.5 ± 1.1, and 11.8 ± 1.2, respectively, P = 0.013; and 21.3 ± 1.7, 29.9 ± 1.6, and 22.5 ± 1.8, respectively, P = 0.022. The rate of sexual intercourse doubled during the period of maximal treatment effect (P < 0.0001). Conclusions CO2 laser treatment has both a statistically and clinically significant effect on participants’ complaints and sex‐life, which wanes by 6 months post‐treatment. Laser therapy seems to be safe in the short term, with no serious adverse events reported in the current study. Further studies are warranted to determine the long‐term safety and the efficacy of maintenance laser treatments. Lasers Surg. Med. © 2020 Wiley Periodicals LLC

Fractional Microablative CO2 Laser‐Related Histological Changes on Vulvar Tissue in Patients With Genitourinary Syndrome of Menopause

“…Despite the improvement being significant in all clinical outcomes, the main improvement was found in VuHI, which appears as a further novel finding. This finding makes fractional microablative CO 2 laser as an effective tool for vulvar symptoms and signs of GSM, as well as for vaginal ones (as reported in previous studies and also confirmed by our results [14,16,19–23,40–44]). Other major improvements were observed for dyspareunia, vaginal dryness, reduced sensitivity during sexual intercourse, and vulvodynia.…”

The Fractional CO2 Laser for the Treatment of Genitourinary Syndrome of Menopause: A Prospective Multicenter Cohort Study

“…In particular, the heavier atrophy related to burning, dyspareunia on vaginal opening, and lower one‐third of the vagina could be markedly improved [14]. So, based on these changes, the urinary symptoms and sexual function and vaginal laxity were significantly effect in the intravaginal fractional CO 2 laser groups [28,29], which laser group showed a statistically significant reduction in nocturia compared with that of the promestriene group [28].…”

Pixel CO2 Laser for the Treatment of Stress Urinary Incontinence: A Prospective Observational Multicenter Study

“…Recently, there have been some studies evaluating the efficacy of CO 2 laser treatment in women with a lack of sexual interest due to vaginal laxity, which shows a statistically significant short‐term effect (≤6 months) on women's sex life [27]. An interesting randomized clinical study was performed by Aguiar et al [28] showing the superior influence of fractional intravaginal CO 2 laser treatment on symptoms of OAB and nocturia in comparison with vaginal lubricant and topical estrogen (promestriene).…”