Laser treatment for genitourinary syndrome of menopause

Phillips, Christian; Hillard, Tim; Salvatore, Stefano; Cardozo, Linda; Toozs‐Hobson, Philip

doi:10.1111/1471-0528.17195

Cited by 10 publications

(7 citation statements)

References 45 publications

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“…should be used cautiously and primarily as a part of research until more robust evidence is available [83].…”

Section: Discussionmentioning

confidence: 99%

Vaginal Laser Treatment for the Genitourinary Syndrome of Menopause in Breast Cancer Survivors: A Narrative Review

Okui

2023

Cureus

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Vulvovaginal atrophy (VVA) is a chronic condition resulting from reduced estrogen levels during menopause. The North American Menopause Society and the International Society for the Study of Women's Sexual Health suggested the term "genitourinary syndrome of menopause" (GSM) to indicate the broader aspects of VVA. Breast cancer treatments, such as chemotherapy and endocrine therapy, can induce early and abrupt menopausal symptoms, including GSM, which negatively affects sexual function and the quality of life of the survivors. Vaginal laser therapy has emerged as a safe and effective option for the management of GSM in breast cancer survivors (BCSs). Two main types of lasers, the non-ablative erbium:YAG laser and fractional microablative CO 2 vaginal laser, have been evaluated for GSM treatment. While there are few randomized controlled trials (RCTs) on the subject of BCSs, a wealth of prospective and retrospective studies have highlighted the beneficial effects of vaginal laser therapy on the symptoms of VVA, vaginal health, sexual function, and overall quality of life. More comprehensive research is essential to confirm its enduring effectiveness and safety, with a focus on conducting standardized and meticulously controlled investigations. This study is a narrative review that summarizes clinical trials ranging from the earliest to the most recent ones on laser treatment for GSM in BCSs.

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“…should be used cautiously and primarily as a part of research until more robust evidence is available [83].…”

Section: Discussionmentioning

confidence: 99%

Vaginal Laser Treatment for the Genitourinary Syndrome of Menopause in Breast Cancer Survivors: A Narrative Review

Okui

2023

Cureus

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“…27 The main factor accelerating the growth of the laser market was the need of both women and HCPs to fill a very relevant gap in GSM treatment deriving from contraindications or low preferences for hormone therapies. 28 However, scientific societies [18][19][20]29,30 and regulatory agencies, e.g. the Food and Drug Administration (FDA), awaits further efficacy and safety data before officially endorsing energy-based techniques for the management of GSM.…”

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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“…Since the first use of vaginal laser in 2014, there has been growing enthusiasm regarding the use of vaginal energy-based devices (EBD) to treat vaginal atrophy and other associated urogynecological conditions. Several publications describe the potential use of these devices, especially the laser, which demonstrates that their use is already a reality in clinical practice despite limited evidence regarding long-term efficacy and safety [1][2][3][4] .…”

Section: Introductionmentioning

confidence: 99%

“…There are three main types of non-surgical (for tissue remodeling) EBD with applicability for vaginal use: micro ablative fractional CO 2 laser, Er:YAG laser, and temperature-controlled radiofrequency (RF). As they have not yet been recommended for general use, they are not treatments covered by health insurance or affordable for the general population 3,4 .…”

Section: Introductionmentioning

confidence: 99%

Applicability of vaginal energy-based devices in urogynecology: evidence and controversy

Machado¹,

Judice

Riccetto

et al. 2023

Rev. Assoc. Med. Bras.

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SUMMARY OBJECTIVE: This study aimed to analyze the evidence and controversies about the use of vaginal energy-based devices (laser and radiofrequency) for treatment of genitourinary syndrome of menopause, recurrent urinary tract infection, urinary incontinence, and genital prolapse through a literature review. METHODS: A search of literature databases (PubMed, Medline) was performed for publications in December 2022. Keywords included genitourinary syndrome of menopause, vaginal laxity, vaginal/vulvovaginal atrophy, urinary tract infection, urgency incontinence, frequency, urgency, stress urinary incontinence, genital prolapses AND energy-based devices, AND vaginal laser, AND vaginal radiofrequency, AND CO2 laser, AND Er:YAG laser. Publications in English from the last 7 years were reviewed and selected by the authors. RESULTS: The literature regarding vaginal energy-based devices in the treatment of urogynecological conditions is primarily limited to prospective case series with small numbers and short-term follow-up. Most of these studies showed favorable results, improvement of symptoms with low risk, or no mention of serious adverse events. Consensus statement documents from major medical societies suggest caution in recommending these therapies in clinical practice until more relevant data from well-designed studies become available. CONCLUSION: The potential of the vaginal laser and radiofrequency as a therapeutic arsenal for the evaluated urogynecological conditions is great, but qualified research must be done to prove their efficacy and long-term safety, define application protocols, and recommend the use of these technologies in clinical practice.

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Laser treatment for genitourinary syndrome of menopause

Cited by 10 publications

References 45 publications

Vaginal Laser Treatment for the Genitourinary Syndrome of Menopause in Breast Cancer Survivors: A Narrative Review

Vaginal Laser Treatment for the Genitourinary Syndrome of Menopause in Breast Cancer Survivors: A Narrative Review

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

Applicability of vaginal energy-based devices in urogynecology: evidence and controversy

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