Using Hydrating and Re-Epithelizing Gels as an Adjuvant Treatment of Fractional CO2 Laser in the Management of Genitourinary Syndrome of Menopause: A Clinical Case Series

Genitourinary syndrome of menopause (GSM) is one of the most prevalent conditions linked with the menopause and greatly impacts the quality of life. In this prospective cases series studies, 22 patients of 60 ± 6.34-year-old were treated with niosomal hyaluronic acid and Centella asiatica-based vaginal gel as an adjuvant treatment to the CO2 laser therapy for the GSM for 5 months. The aim was to assess the microbiota improvement along with other parameters related with GSM. After treatment, the amount of Lactobacillus spp. population was significantly increased from 4.23 ± 2.23 to 5.36 ± 2.50 log CFU/g. Specifically, L. gaserii from 1.66 ± 1.60 to 2.49 ± 1.48 log CFU/g and L. inners from 1.47 ± 1.5 to 2.64 ± 2.7 log CFU/g, respectively. Importantly, Enterobaceriaceae spp., showed a significant decrease after treatment. Other variables such as a significant reduction of vaginal pH from 6.68 ± 0.46 to 5.5 ± 0.56 log CFU/g, a significant increase of Bachman index from 10.27 ± 2.29 to 16 ± 2.18 log CFU/g. Lastly and improvement of Sandvik index from 2.52 ± 2.61 to 1.09 ± 0.81 log CFU/g were observed. FSFI significantly improved after treatment from 2.14 ± 1.45 to 3.08 ± 1.41. 95 log CFU/g. 5% of patients declared being satisfied or very satisfied with the treatment. Hence, these results point that this therapeutic approach might be useful for the management of GSM; new controlled studies must be done in other to fully determine its effectiveness.