Which symptoms can actually be improved by vaginal laser treatment ?
The benefits of vaginal laser treatment have mainly been studied for vaginal dryness, burning, discomfort and pain during intercourse, particularly after menopause.
Declining oestrogen levels may make the vaginal mucosa thinner, less elastic and less lubricated. These changes form part of the genitourinary syndrome of menopause and may cause these symptoms.
Several studies report improvement after vaginal laser treatment. However, this improvement is less clear in trials comparing laser treatment with a placebo treatment. Current scientific evidence therefore does not allow its effectiveness to be guaranteed in every patient.
The result depends particularly on the origin of symptoms and the individual response to treatment.
What are the benefits of local, non-hormonal vaginal treatment ?
Vaginal laser treatment acts locally on vaginal tissues, without systemic administration of medication or systemic exposure to oestrogens.
This non-hormonal approach may be considered in certain patients seeking local treatment. However, this does not mean that laser treatment replaces local hormonal treatments. Vaginal oestrogens remain a therapeutic option for the genitourinary syndrome of menopause when indicated.
In a woman who does not wish to use hormones or whose medical history requires specific discussion about their use, the non-hormonal nature of laser treatment may be considered when choosing treatment.
Can vaginal laser treatment improve comfort during intercourse ?
Vaginal laser treatment can improve comfort during intercourse when pain is associated with vaginal dryness or mucosal changes on which the laser can act.
Its aim is not to directly increase desire, sensitivity or orgasm. Any improvement in sexual function is mainly associated with reduced dryness and pain during intercourse.
However, dyspareunia may have other causes, including a scar, infection, a vulval condition, excessive pelvic floor contraction or a gynaecological disorder. In these situations, vaginal laser treatment will not be effective if it does not treat the cause of pain.
The cause of dyspareunia must therefore be identified before vaginal laser treatment is offered.
Is vaginal laser treatment effective for vaginal laxity ?
Vaginal laser treatment may improve a sensation of laxity when associated with changes in vaginal tissues, but does not treat every cause of vaginal laxity.
After childbirth, this sensation may also be associated with pelvic floor weakness, a perineal injury or prolapse. Identifying the cause is essential because these situations require different treatments.
Muscle weakness may require pelvic floor rehabilitation, while prolapse requires specific assessment. Laser treatment cannot repair a muscle injury or correct prolapse.
Its non-surgical nature is therefore a benefit only when the sensation of laxity can be improved through action on vaginal tissues.
Can vaginal laser treatment help with minor urinary leakage ?
Vaginal laser treatment has been studied for mild to moderate stress urinary incontinence.
Stress incontinence is leakage caused by coughing, sneezing, running, jumping or another effort that increases abdominal pressure.
It must be distinguished from urgency incontinence, in which leakage is preceded by a sudden urge that is difficult to control.
Studies of vaginal lasers report variable results, and comparative evidence remains insufficient to consider laser treatment a standard treatment for stress incontinence.
What are the limitations of vaginal laser treatment ?
Laser treatment offers little benefit when the symptom is mainly caused by a structure or disease on which it does not act.
Pain associated with pelvic floor hypertonicity requires different management. An infection must be treated. Prolapse cannot be corrected by mucosal remodelling. Urgency incontinence must not be equated with stress incontinence.
The same caution applies to vaginal dryness. After menopause, it may form part of a genitourinary syndrome that must be assessed as a whole and for which several treatments are available.
Precisely identifying the cause of the symptom therefore avoids using laser treatment for an indication it cannot correct.
Article written by Dr Valeria Romano
Dr Valeria Romano supports each patient with a comprehensive approach to the aesthetics of the face, body and intimate areas, and to skin and hair quality. Every treatment is based on a personalised medical assessment.
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