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 laser patients are usually treated once a month to possess step three months. Ladies are taught so you’re able to refrain from gender for around dos months shortly after medication. Laser treatments target brand new pussy just, not the latest perineum. Published research ways the providers need to be regular annually. 68,69
The fresh Emergency room:YAG laserlight has actually displayed encouraging outcomes for breast cancer survivors. In one data 43 postmenopausal breast cancer survivors had been given step three laser beam apps all the 1 month. The episodes was assessed prior to cures and once step one, step 3, six, twelve, and you will 1 . 5 years, having fun with dos actions: subjective artwork analogue size (VAS) and you may objective Genital Wellness Directory escort services in Miramar Get (VHIS). For everyone of your feamales in the analysis, genital dry skin, VAS, dyspareunia, and you can VHIS score rather improved following 3rd medication. The new ratings denied from the 12 and eighteen months but remained somewhat increased compared with baseline. The research ways “vaginal erbium laserlight is effective and you will safe for the treatment of genitourinary disorder of menopausal inside cancer of the breast 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 step one. Improvement in sexuality-related details certainly women given carbon laserlight treatment to own vulvovaginal atrophy once step three, cuatro, and you will 5 treatments.
The newest article writers figured laser beam treatment can get donate to complete regression out-of dyspareunia and you can dryness within the an amount-response trends. An additional last otherwise fifth training may after that enhance the GSM symptom-free rate.
Radiofrequency equipment having vulvovaginal restoration
Radiofrequency equipment are definitely the current alternatives for treatments for VVA. The latest radiofrequency solutions is monopolar, bipolar, and you will multipolar equipment. I’ve fewer knowledge in order to validate the safeguards and you will capabilities compared with 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.