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 Er:YAG laserlight customers are addressed once a month getting step three months. Women are trained to refrain from gender for around 2 weeks after medication. Laser treatments address the fresh snatch just, maybe not brand new perineum. Typed research implies this new treatments have to be frequent per year. 68,69
New Er:YAG laser beam has displayed guaranteeing results for cancer of the breast survivors. In one investigation 43 postmenopausal cancer of the breast survivors was addressed with 3 laser beam programs most of the 1 month. The episodes had been examined ahead of cures and shortly after step 1, 3, 6, several, and you can 1 . 5 years, playing with 2 methods: subjective visual analog level (VAS) and purpose Vaginal Fitness List Score (VHIS). For everybody of one’s women in the analysis, genital dry skin, VAS, dyspareunia, and you will VHIS ratings significantly increased after the third treatment. The newest score refused at twelve and you may 18 months but were still significantly enhanced compared with baseline. The research suggests “vaginal erbium laser beam is very effective and you will not harmful to the management of genitourinary problem of menopausal in 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.
Contour 1. Change in sexuality-associated variables certainly one of females addressed with carbon dioxide laserlight therapy to own vulvovaginal atrophy just after step three, cuatro, and you will 5 service.
The fresh article writers determined that laser beam procedures get sign up to complete regression out-of dyspareunia and dry skin from inside the an amount-response trend. An additional next or fifth tutorial will get subsequent improve GSM symptom-100 % free price.
Radiofrequency gadgets to own vulvovaginal rejuvenation
Radiofrequency gadgets is the most recent options for treatment of VVA. The brand new radiofrequency providers tend to be monopolar 
, bipolar, and you will multipolar products. I have far fewer studies so you’re able to validate its coverage and you can functionality compared with cosmetic 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
Review of nonsurgical answer 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.
