Vaginal LASER and estrogen comparison in Genitourinary Syndrome of Menopause

This study aims to compare the efficacy of CO2 fractionated laser therapy and topical estrogen treatment in managing Genitourinary Syndrome of Menopause (GSM). A total of 88 patients diagnosed with GSM were included in this retrospective study. Of these, 39 received CO2 fractionated laser treatment, while 49 were treated with topical estrogen. Patients whose treatment was completed 1 to 1.5 months prior and had pre-treatment Vaginal Health Index (VHI) and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) scored recorded were included in the study. These patients were invited for a follow-up visit, during which post-treatment VHI and ICIQ-SF scores were assessed by a physician. Both the laser and estrogen groups showed significant improvements in VHI and ICIQ-SF scores after treatment (p < 0.00001 for both groups). No statistically significant difference was found between the post-treatment VHI and ICIQ-SF scores of the two groups (p < 0.923 and p < 0.579, respectively). Although there was no significant difference in the treatment efficacy between estrogen and CO2 fractionated laser therapy, there was a considerable difference in cost, with CO2 fractionated, with laser treatment being 23-24 times more expensive. Therefore, CO2 fractionated laser therapy, which shows similar short-term efficacy to topical estrogen, may be more suitable for patients where hormone therapy is contraindicated.