Photothermal tissue reconstruction and the use of phytoestrogens in the treatment of genitourinary menopausal syndrome

Abstract

Introduction. Genitourinary syndrome of menopause (GSM) is a complex of symptoms resulting from changes to the vulvovaginal region, urethra and bladder due to estrogen and other sex steroid deficiency. Vulvovaginal atrophy is one of its manifestations, and vaginal dryness, dyspareunia, burning and itching are the most common symptoms.Aim. To analyse 20 clinical cases of the use of innovative laser procedures combined with phytoestrogens in patients with vulvovaginal atrophy as a symptom of GSM vs the standard systemic protocol for menopausal hormone therapy.Materials and methods. A clinical case-control study was conducted among 20 postmenopausal women. The age of the subjects ranged from 50 to 65 years with amenorrhea for at least 1 year, a follicle-stimulating hormone level of >30 IU/L and various presentations of GSM. The women were divided into two groups: group 1 (n = 10) received laser therapy combined with phytoestrogens, group 2 (n = 10) received systemic menopausal hormonal therapy. To evaluate the results, a survey with a specialized international vulvovaginal symptom questionnaire (VSQ) was carried out to determine the vaginal health index scores before and after treatment.Results. After treatment, both groups showed significant improvement in the form of the reduction or disappearance of symptoms of vulvovaginal atrophy. The prescription of phytoestrogens provided an additional positive effect after 3 sessions of carbon dioxide laser treatment.Conclusion. The carbon dioxide laser exposure resulted in the reduction or disappearance of the local symptoms of climacteric syndrome in the form of GSM, and the use of phytoestrogens as part of Mense BAA supplemented the treatment of psychoemotional and neurovegetative changes, which allowed us to make a conclusion about the feasibility, high efficiency and safety of the complex treatment for women, who do not wish to take menopausal hormone therapy and (or) have absolute contraindications. However, further research on the laser technologies and other non-hormonal techniques to treat GSM is required to carry out a more complete and accurate assessment of the effectiveness and safety of these treatments.