Vaginal laser therapy for urogenital symptoms in postmenopausal women and breast cancer survivors

Abstract

Introduction: Genitourinary syndrome of menopause (GSM) is common after natural menopause as well as in women with induced menopause due to endocrine therapy and/or oophorectomy following breast cancer. Vaginal laser therapy is a nonhormonal treatment option that appears to alleviate GSM symptoms in natural menopause; however, women with induced menopause may respond differently. The aim of this study was thus to evaluate the efficacy and safety of laser treatment on GSM in postmenopausal women and breast cancer survivors. Methods: A total of 34 women were enrolled in the study, each completing three treatments at monthly intervals. After each treatment, sexual function was assessed with PISQ-12, urinary incontinence and overactive bladder symptoms were measured using ICIQ-UI SF and ICIQ-OAB, and the improvement of urinary incontinence was measured using PGI-I and PGI-S. Results: At the time of follow-up, one year after the start of treatment the total PISQ-12 score had significantly increased in both groups compared to baseline (33 to 35.5, difference 2.5, 95% CI: 0.9-4.3). As assessed by ICIQ-UI SF scores, vaginal laser therapy also improved urinary incontinence from 5.3 at baseline to 3.4 at one-year follow-up (difference 1.9, 95% CI:0.4-3.1) for the total group. Improved urgency score from 3.1 at baseline to 2.5 at one-year follow-up (difference 0.7, 95% CI:0.02-1.5) and less leakage after urgency 3.1 at baseline to 2.8 at one-year follow-up (difference 0.8, 95% CI:0.05-1.5) were also reported.  No complications were observed. Conclusion: Vaginal laser therapy appears to be safe and may reduce GSM symptoms in postmenopausal women and breast cancer survivors. Separate randomized controlled studies are needed.