The newest Emergency room:YAG is considered the “next generation” out-of thermotherapy to have VVA

Both proceed this link here now 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 managed once per month to possess step three days. Women can be educated to help you avoid intercourse for around dos weeks immediately following treatment. Laser treatments address brand new snatch just, not brand new perineum. Penned analysis indicates brand new providers need to be regular per year. 68,69

The brand new Er:YAG laser has demonstrated guaranteeing results for cancer of the breast survivors. In one study 43 postmenopausal breast cancer survivors was in fact addressed with step 3 laserlight software all of the thirty day period. The symptoms were assessed prior to cures and you may immediately following step 1, 3, 6, several, and eighteen months, playing with dos methods: subjective visual analogue measure (VAS) and you may purpose Vaginal Wellness List Score (VHIS). For everybody of one’s ladies in the study, genital dry skin, VAS, dyspareunia, and VHIS scores notably improved after the third cures. The fresh ratings refused during the several and you may eighteen months however, remained rather increased in contrast to baseline. The research implies “vaginal erbium laser is very effective and you will not harmful to the treating of genitourinary syndrome off menopausal from inside the 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.

Profile step 1. Improvement in sexuality-relevant variables certainly one of lady given carbon dioxide laser beam therapy to possess vulvovaginal atrophy shortly after 3, 4, and 5 treatments.

The article writers figured laser beam therapy get donate to complete regression out-of dyspareunia and you can dryness within the a dose-impulse styles. An extra 4th or fifth example get further boost the GSM symptom-totally free price.

Radiofrequency equipment for vulvovaginal restoration

Radiofrequency products certainly are the newest options for treatments for VVA. The radiofrequency solutions are monopolar, bipolar, and you can multipolar gadgets. You will find a lot less degree to help you validate its safety and you may features in contrast 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 means to fix 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.