Both CO2 and Er:YAG lasers have been evaluated for their ability to rejuvenate vaginal tissue. 64 The Er:YAG laser emits light at a wavelength of 2.94 µm and is 16 times more highly absorbed by water than the CO2 laser light. 65-67 Because of this higher water absorption rate, the Er:YAG causes much more superficial penetration and ablation of tissue. Most importantly, the Er:YAG laser does not increase the zone of thermal damage with each subsequent laser impact, as the CO2 laser does. Currently, the Er:YAG is the most commonly used laser treatment for VVA.
To your Emergency room:YAG laser patients are usually addressed once a month for step 3 days. Women can be coached so you’re able to abstain from sex for around dos days after treatment. Cosmetic laser treatments address the fresh snatch only, maybe not new perineum. Wrote studies means brand new solutions must be constant a-year. 68,69
New Emergency room:YAG laserlight keeps displayed promising outcomes for breast cancer survivors. In one data 43 postmenopausal cancer of the breast survivors have been treated with step 3 laser beam programs the 1 month. Their symptoms was indeed assessed ahead of treatment and you will immediately following step 1, step three, six, a dozen, and you may eighteen months, playing with dos procedures: subjective artwork analogue scale (VAS) and purpose Vaginal Fitness Index Score (VHIS). For everyone of your own feamales in the research, genital dryness, VAS, dyspareunia, and you can VHIS results significantly enhanced pursuing the third medication. The fresh new scores denied from the a dozen and you may 18 months however, were still notably enhanced compared to standard. The research implies “vaginal erbium laser is very effective and you will not harmful to the treatment of genitourinary syndrome out of menopause within the breast cancer survivors.” 68
Using laser devices for VVA truly is a formative science, and we do not have definitive answers about the optimal number and frequency of treatments. Athanasiou and Pitsouni aimed to address this question in a recently published study. 69 In their study, 55 women received 3 sessions of CO2 laser therapy, 53 had an additional fourth session, and 22 had an additional fifth session. Results of their study are summarized in Figure 1.
Figure step one. Improvement in sexuality-relevant details among girls given carbon dioxide laser medication to have vulvovaginal atrophy after 3, 4, and you can 5 service.
The new people determined that laser procedures could possibly get subscribe done regression of dyspareunia and you can dryness during the a dose-impulse manner. A supplementary fourth otherwise fifth concept may next increase the GSM symptom-free rate.
Radiofrequency products having vulvovaginal restoration
Radiofrequency products is the current options for therapy of VVA. The radiofrequency services become monopolar, bipolar, and you will multipolar gizmos. You will find far fewer education in order to corroborate their security and effectiveness weighed against laser treatments.
Radiofrequency treatments are repeated weekly to monthly, usually for a total of 3 treatments. While the CO2 and Er:YAG lasers treat only the vagina, the radiofrequency devices rejuvenate the perineum as well. Women can have intercourse the same day. Like the laser treatments, the effects of radiofrequency treatments diminish over time and likely need to be repeated annually. 70
Overview of nonsurgical solution to vulvovaginal atrophy
Both the laser and radiofrequency treatments offer viable options for nonhormonal treatment of VVA. The CO2 and Er:YAG lasers have been used clinically for a couple of decades, while the radiofrequency devices offer promising new treatment options. The Er:YAG laser has been shown to benefit both VVA and mild to moderate stress urinary incontinence (SUI). 71 Less is known about the effectiveness of the radiofrequency devices for treating SUI, but they have the added benefit of treating the perineum as well as vaginal tissue. Insurance companies do not currently cover either laser or radiofrequency treatments for VVA or SUI, and the out-of-pocket expenses are customarily $1,000 per treatment.