The heat is on

Hillard, Tim; Nappi, Rossella E.

doi:10.1080/13697137.2020.1828855

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…[18][19][20][21][22] In the last decade, energy-based treatments have emerged as a possible non-hormonal option to manage GSM symptoms in menopausal women. 23 This minimally invasive technology seemed particularly attractive in BCSs who needed to avoid hormonal exposure. 24 Vaginal laser therapy is the most studied technique to improve vaginal health through controlled heat-associated micro trauma in vaginal tissue, which leads to activation of fibroblasts in the extracellular matrix and promotes collagen and elastic fibers deposition, angiogenesis, and tissue remodeling.…”

Section: Introductionmentioning

confidence: 99%

Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Current Perspectives on the Role of Laser Therapy

Cucinella¹,

Tiranini²,

Cassani³

et al. 2023

IJWH

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Genitourinary syndrome of menopause (GSM) is a frequent consequence of iatrogenic menopause or anti-estrogenic adjuvant therapies in breast cancer survivors (BCSs). GSM may profoundly affect sexual health and quality of life, and a multidimensional unique model of care is needed to address the burden of this chronic heterogeneous condition. Severe symptoms may be insufficiently managed with non-hormonal traditional treatments, such as moisturizers and lubricants, recommended as the first-line approach by current guidelines, because concerns exist around the use of vaginal estrogens, particularly in women on aromatase inhibitors (AIs). Vaginal laser therapy has emerged as a promising alternative in women with GSM who are not suitable or do not respond to hormonal management, or are not willing to use pharmacological strategies. We aim to systematically review current evidence about vaginal laser efficacy and safety in BCSs and to highlight gaps in the literature. We analyzed results from 20 studies, including over 700 BCSs treated with either CO 2 or erbium laser, with quite heterogeneous primary outcomes and duration of follow up (4 weeks–24 months). Although evidence for laser efficacy in BCSs comes mostly from single-arm prospective studies, with only one randomized double-blind sham-controlled trial for CO 2 laser and one randomized comparative trial of erbium laser and hyaluronic acid, available data are reassuring in the short term and indicate effectiveness of both CO 2 and erbium lasers on the most common GSM symptoms. However, further studies are mandatory to establish long-term efficacy and safety in menopausal women, including BCSs.

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Section: Introductionmentioning

confidence: 99%

Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Current Perspectives on the Role of Laser Therapy

Cucinella¹,

Tiranini²,

Cassani³

et al. 2023

IJWH

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“…However, there is limited evidence to support the adoption of such devices. In 2018, the United States Food and Drug Administration (FDA) 1 issued a warning against the use of EBDs, including laser, to perform ‘vaginal rejuvenation’ or vaginal cosmetic procedures, and caution has been advised, calling for greater evidence on the efficacy and safety of vaginal lasers 2,3 …”

Section: Introductionmentioning

confidence: 99%

“…In 2018, the United States Food and Drug Administration (FDA) 1 issued a warning against the use of EBDs, including laser, to perform 'vaginal rejuvenation' or vaginal cosmetic procedures, and caution has been advised, calling for greater evidence on the efficacy and safety of vaginal lasers. 2,3 The scope of this Scientific Impact Paper is confined to outlining the level of evidence available for the use of laser in the treatment of genitourinary syndrome of menopause (GSM), as well as to highlight areas of uncertainty and debate.…”

Section: Introductionmentioning

confidence: 99%

Laser treatment for genitourinary syndrome of menopause

Phillips¹,

Hillard²,

Salvatore³

et al. 2022

BJOG

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Plain language summaryGenitourinary syndrome of menopause (GSM) is the term used to describe the group of symptoms including vaginal pain, vaginal dryness, itching, pain during sexual intercourse and fragile vaginal tissues as well as urinary symptoms including urinary frequency, urgency, incontinence, blood in the urine (haematuria) and recurrent urinary tract infections that occur due to a lack of the hormone estrogen.These symptoms can have a significant negative impact on psychosexual issues, sexual function and quality of life in postmenopausal women. Traditionally women have been treated with vaginal lubricants, vaginal moisturisers or low‐dose vaginal estrogens.Lasers have been used in the cosmetic industry for collagen remodelling and repair of the skin. Therefore, it has been suggested that laser therapy may be used on the vagina as an alternative treatment for GSM. A review of all the published studies assessing the safety and efficacy of laser therapy for GSM have shown promising beneficial results. The majority of studies to date have been small, short‐term, observational studies. However, there are randomised controlled trials underway. Laser treatment may be beneficial for the symptoms of GSM but until more robust evidence is available it should not be adopted into widespread practice, and should be used as part of a research study only.

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