Why does vaginal dryness often appear after menopause ?
After menopause, declining oestrogen levels gradually change the vaginal mucosa and may cause dryness.
The mucosa becomes thinner and more fragile. Lubrication decreases and tissue elasticity changes.
Dryness may then be accompanied by burning, irritation, itching or pain during intercourse. These symptoms form part of the genitourinary syndrome of menopause.
Unlike certain menopausal symptoms, vaginal dryness does not necessarily disappear spontaneously over time.
How can vaginal laser treatment act on dryness ?
Laser treatment acts on the vaginal mucosa ; it does not directly provide lubrication or replace oestrogens.
The energy delivered induces a controlled tissue reaction. The intended changes concern, in particular, the structure of the vaginal epithelium and underlying connective tissue.
The aim is to improve tissue condition to subsequently reduce certain symptoms, including dryness.
The mechanism therefore differs from that of a lubricant, which temporarily reduces friction, or local hormonal treatment, which acts on oestrogen-sensitive tissues.
Does vaginal dryness genuinely improve after laser treatment ?
Yes, reduced dryness is observed in many studies after vaginal laser treatment. However, this improvement alone does not prove that laser treatment is responsible.
Observational studies, in which all women know they are receiving treatment, frequently report reduced symptoms.
Placebo-controlled trials provide different information : they compare laser treatment with a sham procedure. In these studies, improvement was also observed in the placebo group.
The scientific question is therefore not simply whether dryness decreases after laser treatment, but whether it decreases more than after sham treatment.
Is laser treatment indicated for every case of vaginal dryness ?
No. Before laser treatment is offered, the cause of dryness must be identified.
Vaginal dryness may be associated with menopause, but also with breastfeeding, certain medicines or various gynaecological conditions.
A sensation of dryness may also be confused with irritation, infection or a vulval condition.
Performing laser treatment without identifying the cause may therefore lead to treating the mucosa when the problem requires different management.
Can laser treatment be considered when you do not wish to use hormones ?
Yes. Vaginal laser treatment may be considered in certain women who do not wish to use hormonal treatment, but it is not routinely the best non-hormonal alternative.
Other non-hormonal options exist, including vaginal moisturisers and lubricants. Moisturisers are used regularly to improve vaginal comfort, whereas lubricants mainly reduce friction and discomfort during sexual intercourse.
In women with a history of hormone-dependent cancer, treatment selection requires particularly rigorous assessment. Observational studies of laser treatment often report improved symptoms, but placebo-controlled trials have not demonstrated a clinically significant benefit clearly attributable to the laser.
Can laser treatment treat dryness associated with painful intercourse ?
It may be discussed when pain is directly associated with dryness and changes in the vaginal mucosa.
Dry, fragile mucosa increases friction during penetration and may cause burning or pain.
However, not all pain during intercourse comes from dryness. Infection, a vulval condition, a scar or excessive pelvic floor contraction may also cause dyspareunia.
If pain persists despite improved dryness, another cause must be investigated.
How can you know whether laser treatment is indicated for vaginal dryness ?
It is first necessary to confirm that the sensation of dryness genuinely corresponds to a change in the vaginal mucosa and identify its cause.
In a postmenopausal woman, other manifestations of the genitourinary syndrome of menopause must be investigated and mucosal condition assessed. Treatments already used, their effectiveness and any contraindications must also be considered.
In a younger woman, the appearance of dryness requires investigation, particularly of hormonal, medication-related or gynaecological factors, before laser treatment is considered.
Vaginal laser treatment may therefore improve dryness in some women, but is neither routine treatment nor a solution with guaranteed effectiveness. The cause of dryness must be identified before determining whether laser treatment offers benefits compared with other available treatments.
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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