Background: Genitourinary syndrome of menopause (GSM) majorly caused by
the physiological decline in estrogen, affects up to 90% of menopausal women.
Hormonal therapy seems to be an effective treatment, often not executable for
contraindication or patient’s low compliance to local or systemic medical
therapy. Fractional CO laser therapy is an emerging and effective choice
for women affected by vulvo-vaginal atrophy (VVA), promoting collagen
regeneration and improving blood flow of the vaginal mucosa and elasticity of
tissues. Methods: Ninety-two menopausal Patients affected by
vulvo-vaginal atrophy (VVA) were considered for the present prospective
observational study. All women were treated with Fractional CO laser
Lumenis AcuPulse in a fractionated sequential mode laser pulse. Patients were
requested to complete questionnaires regarding the Female Sexual Functional Index
(FSFI), Female Sexual Distress Scale (FSDS) and severity of Most Bothersome
Symptoms (MBS) at baseline (T0) and at three-month following
three-treatment-sessions (T1). Results: Data indicated a significant
improvement of MBS (vaginal itching (p 0.0001), post-coital vaginal
bleeding (p 0.002), vaginal dryness (p 0.0001),
dyspareunia (p 0.0001) and dysuria (p 0.0001), higher
Vaginal Health Index Score (VHIS) (4.1 1.21; 95% CI = 3.84–4.35) and
reduces pH (–0.53 0.24; 95% CI = 0.48–0.58) after CO laser
treatment. A significantly improvement of FSFI Total score (p
0.0001) and FSDS (p 0.0001) have been demonstrated.
Conclusions: Fractional CO laser improves vaginal health as well
as signs and symptoms associated with GSM, while significantly elevating quality
of life and sexual functionality among postmenopausal symptomatic women.