Fractional Co2 laser vs platelet rich plasma in the treatment of genitourinary syndrome of menopause

Abstract

Menopause is a natural process in a woman's life, which tends to worsen by presenting a series of symptoms and signs such as Genitourinary Menopause Syndrome (GMS). Nowadays, local and systemic hormonal therapy has been shown to be the most effective treatments for these cases, however, non-hormonal treatments such as fractional CO2 Laser and Platelet Rich Plasma have emerged as alternatives. The objective of this clinical trial was to compare the effectiveness of fractional CO2 Laser vs. Platelet Rich Plasma in the treatment of GMS. Before applying the protocol and 30 days after the third treatment session, the following samples were taken: vaginal pH, vaginal cytology and biopsy, vaginal health index, and female sexual satisfaction index. Patients treated with fractional CO2 Laser improved dryness, urinary urgency and decreased sexual desire by 100%, compared to those treated with PRP (90%). Vaginal pH reached normal levels (pH 5) with both treatments. Cytology showed an improvement in the patients treated with fractional CO2 Laser, the quantity of superficial and intermediate cells by 80%, unlike PRP with 60%. Although optical microscopy was used, non- keratinized stratified squamous epithelium was observed in 10% (pretreatment) improved to 50% in patients treated with fractionated CO2 Laser, unlike PRP in 20%. The vaginal health index improved above 15 with both treatments, however, when the FSFI was applied, there was a significant difference of 24.89 versus 14.76, in favor of the CO2 Laser. In summary, the fractional CO2 Laser and Platelet Rich Plasma recommended as an alternative therapy for GMS because it is effective and safe