What effects may appear after vaginal laser treatment ?
A sensation of heat, local irritation, discomfort or vaginal discharge may appear after the session. These effects are generally temporary and mild and gradually decrease.
Their intensity depends particularly on the type of laser, the settings used and the tissue reaction.
Increasing pain, significant burning or unusual bleeding, however, should not be regarded as normal recovery effects.
What complications may occur after vaginal laser treatment ?
The main complications reported with vaginal laser treatment are burns, scarring, pain during intercourse and persistent pain.
A burn is excessive thermal injury to tissues. Abnormal healing may subsequently alter the area's suppleness and cause discomfort or pain.
These complications are not the intended effects of treatment. Significant pain or pain persisting beyond the recovery period requires medical examination.
Are serious complications common ?
Clinical studies report few serious adverse events, but cannot precisely determine their frequency.
This limitation is important. Many studies include few patients, relatively short follow-up or incomplete assessment of adverse effects. A low frequency of complications in these studies therefore does not prove that a rare event cannot occur.
The most recent evidence mainly confirms good short-term tolerability.
Can vaginal laser treatment cause pain during intercourse ?
Yes. Dyspareunia, meaning pain during sexual intercourse, is among the complications reported after certain vaginal laser treatments.
Temporary tenderness or discomfort may occur while the mucosa heals. This reaction must be distinguished from pain that appears after treatment and persists once healing is complete.
If intercourse becomes painful when it was not before laser treatment, or if pain persists beyond the healing period, medical examination is necessary to investigate its cause.
Persistent pain during intercourse is therefore not a normal recovery effect of vaginal laser treatment and must not be dismissed.
Is there a risk of burns with vaginal laser treatment ?
Yes. The laser delivers energy to tissues and a burn is possible if the thermal effect is excessive.
The risk depends on several factors : the technology used, energy delivered, device settings, tissue characteristics and application technique.
A mild sensation of heat immediately after the session is not equivalent to a burn. Intense pain, a worsening burning sensation or the appearance of a lesion should prompt contact with the doctor.
Do all patients have the same level of risk ?
No. The initial condition of the vulva and vagina must be considered before treatment.
Very fragile mucosa, active infection, an undiagnosed lesion, unexplained bleeding or pain of unknown cause require assessment before laser treatment is considered.
This step also avoids attributing a symptom caused by another condition to the genitourinary syndrome of menopause.
Laser treatment must not be performed simply because a patient has dryness, pain or irritation : the cause of the symptom must first be identified.
Do CO₂ and Er lasers have the same safety profile ?
No. CO₂ and Erbium lasers do not have exactly the same tolerability and risk profile because they use different wavelengths and do not act on tissues in the same way.
Fractional CO₂ laser treatment used vaginally is generally micro-ablative. Erbium lasers can be used in different modes, including ablative or non-ablative modes.
The depth of action and thermal effect also depend on the device used and settings chosen. The risk of adverse effects therefore cannot be considered identical for all vaginal lasers.
This difference is important when interpreting studies : results obtained with a particular type of laser, device and protocol cannot automatically be generalised to all vaginal lasers.
How can risks be reduced before vaginal laser treatment ?
Several precautions help reduce risks before and after vaginal laser treatment :
• Check the indication : the laser must correspond to the problem identified. Infection, prolapse or a pelvic floor disorder require different management.
• Look for infection or a lesion before the session : unusual discharge, itching, pain, a vulval or vaginal lesion or unexplained bleeding must be assessed before treatment.
• Choose an appropriate laser and settings : the technology, energy delivered and settings must be adapted to the indication and tissue condition.
• Follow instructions after the session : sexual intercourse and activities that may irritate the area must be avoided during the specified recovery period.
• Monitor recovery : increasing pain, significant burning, unusual bleeding, abnormal discharge or fever require medical advice.
Medical assessment before vaginal laser treatment therefore confirms the indication, rules out a contraindication and adapts treatment to each patient.
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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