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J Eur Acad Dermatol Venereol. 2020 Apr;34(4):716-726. doi: 10.1111/jdv.16066. Epub 2019 Dec 5.

Review of non-invasive vulvovaginal rejuvenation.

Photiou L1, Lin MJ2, Dubin DP2, Lenskaya V3, Khorasani H2.
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Abstract
Vulvovaginal atrophy (VVA) or genitourinary syndrome of menopause (GSM) may affect up to 90% of
menopausal women. Features include vulvovaginal atrophy, vulvovaginal laxity, vulvovaginal dryness
and irritation, dyspareunia, anorgasmia and urinary symptoms. The vulva, vagina and bladder are
oestrogen-responsive tissues, but oestrogen replacement therapy is not possible in women who have
hormone-responsive cancers or normal oestrogen levels. Therefore, there is a role for alternative
treatments. To date, three non-surgical energy-based therapies have been proposed: fractional
microablative CO2 laser, erbium:YAG laser and temperature-controlled radiofrequency (RF). Our
objective was to assess the available evidence for the safety and efficacy of erbium:YAG laser,
microablative fractional CO2 laser and RF in the treatment of VVA/GSM. The authors reviewed the
current published literature evaluating these therapies. All three therapies appear safe; however, all the
studies were uncontrolled and used different protocols and outcome measurements. Therefore,
comparison of treatments is difficult. It appears that there is more evidence in favour of the CO2 laser
than the erbium:YAG laser. Both lasers have more evidence than RF. In conclusion, microablative
CO2 laser, erbium:YAG laser and RF may be offered to patients suffering from VVA/GSM as an
alternative or adjunct to conventional therapies. Further well-conducted controlled studies are needed.

© 2019 European Academy of Dermatology and Venereology.

PMID:
 
31714632
 
DOI:
 
10.1111/jdv.16066