Number of vaginal lactobacilli in postmenopausal women with vaginal atrophy before and after treatment with erbium YAG laser, a randomized sham-controlled trial

Abstract

Abstract Primary objective: To evaluate the effect of erbium YAG laser on the number of vaginal lactobacilli in postmenopausal women. Secondary objectives: To evaluate the effects of erbium YAG laser on vaginal atrophy symptoms and vaginal pH in postmenopausal women. Materials and Methods: A total of 44 postmenopausal women meeting inclusion criteria were randomized in laser group (n=22) and sham group (n=22). Vaginal lactobacilli grading, vaginal pH, vaginal atrophy score and vaginal atrophy symptoms (dryness, irritation, soreness, dyspareunia) wereassessed before and after treatment with erbium YAG laser for 2 consecutive times, 4 weeks interval; the results were compared with the effects of sham procedure. Any adverse events after the treatment were recorded. Statistical analysis was performed by using SPSS program and p < 0.05 was considered statistically significant. Results: 44women were included and 5were lost to follow-up. Compared with sham procedure, there was an improvement of vaginal lactobacilli grading in laser group (5/20 in laser group and 1/19 in sham group). However, the improvement did not reach statistically significant (adjusted OR = 5.32, 95%CI = 0.5-56.21). Vaginal atrophy symptoms measured by VAS and vaginal pH were improved in both groups without statistically significant difference between groups. Vaginal “dryness” VAS and vaginal atrophy score after treatment were significantly lowered in laser group compared to sham group. Conclusions: This study showed an improvement in vaginal lactobacilli grading after vaginal laser treatment. However, the difference of vaginal lactobacilli grading after treatment in both groups did not reach statistically significant.