Vaginal Laser Therapy not better than first line therapy for genitourinary syndrome of menopause in breast cancer survivors: JAMA

A new study by Eduard Mension and team found that CO2 vaginal laser therapy (CLT) for genitourinary syndrome of menopause (GSM) in breast cancer survivors who were receiving aromatase inhibitors was safe but not effective than first line care. The findings were published in the Journal of American Medical Association.

GSM is a common condition in menopausal women that affects the vagina and urinary tract, causing symptoms such as dryness, itching, burning, and pain during sexual activity. Breast cancer survivors who receive aromatase inhibitors may experience more severe symptoms of GSM due to reduced estrogen levels, which can exacerbate vaginal dryness and other related symptoms.

The study enrolled 72 breast cancer survivors with GSM who were randomized into two groups, one receiving CLT and the other receiving sham laser therapy (SLT) as a control. Both groups were instructed to use non hormonal moisturizers and vaginal vibrator stimulation as a first-line treatment (FLT).

The results showed that both CLT and SLT groups showed improvements in subjective and objective outcomes (sexual function, vaginal health, quality of life, vaginal maturation index, vaginal epithelial elasticity and thickness) after 6 months of follow-up, but there were no significant differences between the two groups in terms of efficacy.

The study found that CLT was safe, but tolerance was significantly lower in the CLT group than the SLT group. No differences in complications or serum estradiol levels were observed between the two groups.

The study adds to the growing body of evidence on the use of vaginal laser therapy for the treatment of GSM, but more research is needed to establish its long-term safety and efficacy, particularly in breast cancer survivors receiving aromatase inhibitors. While the results of this study are promising, more research is needed before vaginal laser therapy can be recommended as a first-line treatment for GSM in breast cancer survivors.

Source:

Mension, E., Alonso, I., Anglès-Acedo, S., Ros, C., Otero, J., Villarino, Á., Farré, R., Saco, A., Vega, N., Castrejón, N., Ordi, J., Rakislova, N., Ribera, L., & Castelo-Branco, C. (2023). Effect of Fractional Carbon Dioxide vs Sham Laser on Sexual Function in Survivors of Breast Cancer Receiving Aromatase Inhibitors for Genitourinary Syndrome of Menopause. In JAMA Network Open. American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2022.55697