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 the Er:YAG laser beam customers are usually managed once a month to own step three weeks. Women can be educated in order to abstain from gender for at least dos weeks just after medication. Cosmetic laser treatments target the fresh pussy merely, perhaps not the newest perineum. Published study implies the new solutions need to be frequent a year. 68,69
Brand new Emergency room:YAG laser beam enjoys shown promising outcomes for breast cancer survivors. In a single data 43 postmenopausal breast cancer survivors was in fact addressed with 3 laser programs every a month. Their periods had been reviewed ahead of medication and once 1, step 3, six, a dozen, and eighteen months, having fun with 2 tips: subjective graphic analogue scale (VAS) and you will purpose Genital Wellness List Score (VHIS). For everybody of the feamales in the research, genital dryness, VAS, dyspareunia, and VHIS ratings rather enhanced following third procedures. This new ratings rejected at 12 and 18 months but were still notably improved compared to standard. The research suggests “vaginal erbium laser is effective and you can safe for treating genitourinary syndrome out-of menopause in 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.
Shape step 1. Improvement in sexuality-relevant parameters certainly one of females addressed with carbon laser medication to possess vulvovaginal atrophy once step three, 4, and you will 5 treatments.
The fresh new article authors concluded that laser treatment could possibly get sign up to complete regression from dyspareunia and you will dryness during the a serving-reaction trends. An additional next escort services Daly City otherwise fifth concept get next enhance the GSM symptom-free rates.
Radiofrequency devices to have vulvovaginal restoration
Radiofrequency gadgets will be newest alternatives for therapy of VVA. The brand new radiofrequency solutions include monopolar, bipolar, and multipolar gizmos. You will find far fewer studies to validate the cover and you will functionality compared to laser light 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 solution 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.