EFFICACY OF CO₂ LASER AND EXOSOMES IN TREATING GENITOURINARY SYNDROME OF MENOPAUSE

Abstract

Menopause leads to a progressive decline in estrogen levels, often resulting in Genitourinary Syndrome of Menopause (GSM), characterized by vaginal dryness, dysuria, dyspareunia, and recurrent infections, all of which negatively impact quality of life. While hormone therapy remains the conventional treatment, non-hormonal alternatives such as fractional CO₂ laser and exosomes have emerged, promoting vaginal mucosal regeneration. This quasi-experimental study evaluated the effectiveness of a combined treatment protocol using fractional CO₂ laser and exosomes derived from umbilical cord stem cells in 20 women aged 40 to 60 years diagnosed with GSM. Participants underwent three treatment sessions and were assessed through vaginal cytology, vaginal pH, the Bachmann Vaginal Health Index, and the Female Sexual Function Index (FSFI). Results showed significant improvement in both vaginal health and sexual function. Post-treatment, 40% of patients presented superficial cells in cytology (compared to 0% at baseline), and the Bachmann Index reflected a reduction in vaginal atrophy from 90% to 60%. Additionally, all FSFI domains showed statistically significant improvement. No adverse effects were reported. In conclusion, the combination of fractional CO₂ laser and exosomes appears to be a safe and effective alternative for managing GSM, enhancing both genital health and sexual quality of life in menopausal women.