Effectiveness of fractionated co2 laser and hyaluronic acid as combined therapy in patients with genitourinary syndrome of menopause

Abstract

Recently, vaginal laser therapy has been introduced as a new therapeutic option for Genitourinary Syndrome of Menopause (GSM). Additionally, its use in combination therapy with moisturizing substances represents a promising method for introducing these molecules into the body through physical means such as light, as it allows for a more effective absorption. The aim of this study was to determine the effectiveness of CO2 laser and hyaluronic acid as a combined therapy in patients with GSM. The study followed a quasi-experimental, prospective, and longitudinal design. The sample consisted of 20 patients aged between 50 and 60 years, all experiencing symptoms of GSM, and it was divided into two groups. Group 1 received fractional vaginal CO2 laser treatment combined with the application of non-crosslinked hyaluronic acid using mesotherapy technique; Group 2 received only fractional vaginal CO2 laser treatment. Both groups underwent three treatment sessions with a 21-day interval between each session. The most frequent symptoms, Vaginal Health Index (VHI), Female Sexual Function Index (FSFI), and changes in vaginal cytology were evaluated before and one month after the treatment protocol described for each group. The results showed that most patients in Group 1 were between 56 and 60 years old, while those in Group 2 were between 50 and 55 years old. The most frequent symptom in both groups was vaginal dryness, and the VHI significantly improved (p = 0.01) in Group 1. The FSFI showed no improvement in either group. Vaginal cytology improved significantly in both groups. In conclusion, it was determined that fractional vaginal CO2 laser therapy, both in combination with non-crosslinked hyaluronic acid and as a standalone treatment, is safe and effective for the short-term management of GSM symptoms, particularly vaginal dryness.