Background: Fractional CO laser (FCL) has been gradually used in
the management of genitourinary syndrome of menopause (GSM) in recent years, but
the results remain uncertain. We aimed to estimate the efficacy and safety of FCL
as a novel treatment for controlling the GSM, especially sexual dysfunction,
compared with intravaginal estrogen. Methods: The following digital
databases were searched, including PubMed, Web of Science, Cochrane Library, and
Embase. All the studies were limited to randomized controlled trials (RCTs).
Included literatures must be in English, without limitation about region and
race. The pooled dates were analyzed by Review Manger version 5.4 (Cochrane
Collaboration’s Information Management System, London, UK).
Results: 3 RCTs were included, which involved 160 patients, 79 of whom
received FCL treatment, 81 received intravaginal estrogen treatments. This
meta-analysis results showed no statistical significance existed in improving the
patient’s vaginal health index (VHI) (mean difference (MD) = 0.59; 95%
confidence interval (95% CI): –1.07~2.25; p = 0.49)
after FCL treatment. In terms of the female sexual function index (FSFI) total
scores, we observed no improvement without statistical significance (MD = –0.13;
95% CI: –3.32~3.06; p = 0.94). Furthermore, all the
FSFI domains showed no statistical significance. No serious complications were
reported in all included trials. Conclusions: FCL therapy was an
interesting and novel treatment for menopausal female sexual dysfunction.
However, no statistical evidence existed, which recommended that FCL was superior
to intravaginal estrogen. Our results will be confirmed by high-quality and
multicentric RCTs in the future.