Does laser treatment help vulvovaginal atrophy?

A small study shows that treatment with CO2 laser induces histological changes in the epithelium and lamina propria that may result in improvement in symptoms associated with vulvovaginal atrophy (VVA). The research, published in Aesthetic Surgery Journal, was conducted by two ob/gyns in private practice in Kentucky and Florida.

For the study, the clinicians evaluated a series of three monthly fractional CO2 lasers in 40 postmenopausal women. Vaginal health indices of elasticity, fluid volume, pH level, epithelial integrity, and moisture were assessed. The authors also measured self-reported symptoms of vaginal atrophy.

At baseline, objective measurements of vaginal health index (VHI), and subjective measurements of symptoms of VVA, urinary incontinence, and sexual function were reported. The women then were treated extravaginally and internally with a fractional CO2 laser once a month for 3 months. After the last treatment, biopsy samples were taken to evaluate for histological changes to vaginal canal tissue. Follow-up evaluations also were done at 1, 3, 6, and 12 months after treatment was complete.

After the first treatment, VHI improved significantly and that change was maintained with mean improvement of 9.6 ±3.3 (P < 0.001) and 9.5 ±3.3 (P < 0.001) at 6 and 12 months, respectively. At all evaluations, vaginal dryness, itching, and dyspareunia improved significantly (P < 0.05). Histology showed increased collagen and elastin staining and thicker epithelium with more cell layers and a better degree of surface maturation.

The authors said the fractional CO2 laser treatments were well tolerated and that the histological changes associated with them “correlated with clinical restoration of vaginal hydration and pH to premenopausal levels.”