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.
For the Emergency room:YAG laserlight clients are treated once a month getting step 3 weeks. Women are trained in order to refrain from gender for at least 2 weeks shortly after medication. Laser treatments address the fresh new snatch just, maybe not the latest perineum. Composed analysis suggests this new providers should be frequent per year. 68,69
The Er:YAG laserlight enjoys exhibited guaranteeing outcomes for breast cancer survivors. In one single data 43 postmenopausal cancer of the breast survivors were addressed with step 3 laserlight applications all thirty day period. The episodes had been assessed just before medication and just after step one, step three, six, 12, and 1 . 5 years, having fun with 2 methods: subjective graphic analog scale (VAS) and goal Genital Fitness Index Score (VHIS). For everybody of your own women in the study, vaginal dryness, VAS, dyspareunia, and you may VHIS results somewhat enhanced adopting the 3rd cures. This new results denied in the twelve and you will 18 months however, remained significantly increased compared with baseline. The study implies “genital erbium laserlight works well and you will not harmful to the management of genitourinary problem regarding menopause during the 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.
Profile step 1. Improvement in sexuality-related details certainly females addressed with carbon laser medication to possess vulvovaginal atrophy just after step 3, 4, and 5 solutions.
The latest article writers concluded that laser treatment can get donate to complete regression off dyspareunia and dryness inside a dosage-effect styles. An additional last otherwise 5th class get after that increase the GSM symptom-100 % free price.
Radiofrequency devices getting vulvovaginal vitality
Radiofrequency products may be the newest choices for treatments for VVA. Brand new radiofrequency solutions is monopolar, bipolar, and you can multipolar gizmos. I have a lot less degree to help you corroborate its cover and you will effectiveness compared with cosmetic 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
Summary of nonsurgical treatment for 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 escort Huntsville currently cover either laser or radiofrequency treatments for VVA or SUI, and the out-of-pocket expenses are customarily $1,000 per treatment.