CO2 Laser Therapy does not improve Genitourinary Syndrome of Menopause,finds study

Despite some prospective case series showing effectiveness of vaginal laser to treat genitourinary syndrome of menopause (GSM), there is a paucity of placebo-controlled level one evidence.

With this background, researchers undertook the current study to assess the effect of fractional carbon dioxide (CO2) laser therapy to treat GSM against a sham comparator.

As for the study design, the research team conducted a parallel, randomized, double-blind, sham-controlled trial to compare menopausal women treated with fractional CO2 laser against sham treatment for improvement in GSM-related dyspareunia. Three treatments were given 6 weeks apart, and participants attended a 6-month visit from study start for primary (proportion improved) and secondary (vaginal health index, VHI; visual analogue scale, VAS; modified global assessment, PGI-I; Female Sexual Function Index, FSFI; Day-to-Day Impact of Vaginal Aging, DIVA; Urinary Distress Inventory short-form, UDI-6) assessments.

The primary endpoint was a 2-stage improvement in GSM-related dyspareunia from baseline to 6 months determined by a severity scale, and the proportion of subjects who achieved this were compared between groups.

Data analysis revealed the following facts.

• Thirty participants were randomized to laser (n = 14) or sham (n = 16). In the treatment arm, 13 attended all treatments, and 1 attended at least 2 while in the sham arm, 14 attended all treatments, and 2 attended at least 2 treatments.
• Twelve (86%) in the treatment arm and 16 (100%) in the sham arm attended the 6-month visit.
• There were no differences in the proportion improved between treatments and controls (64% vs. 67%, respectively, P = 1.000).
• Both arms showed significant within-group improvements based on VHI and VAS, but not between groups.
• Similar findings were observed on sexual impact questionnaires with improvements within both groups from baseline to 6 months but not by median differences between the groups at 6 months.
• There were no adverse events in either of the arms.

For the full article follow the link: A Double-Blind Randomized Sham-Controlled Trial to Evaluate the Efficacy of Fractional Carbon Dioxide Laser Therapy on Genitourinary Syndrome of Menopause J Sex Med 2021 Mar 20;[EPub Ahead of Print], J Cruff, S Khandwala

Primary source: The Journal of Sexual Medicine