Decreased estrogen levels in postmenopausal women often cause painful intercourse or a lack of desire, however, new research published in the journal of The North American Menopause Soceiety (NAMS) suggests that fractional CO2 laser therapy may help.

Menopause frequently subjects women to genitourinary changes due to a lack of estrogen and subsequent changes in vaginal elasticity, moisture, tissue integrity, and pH levels. These changes can lead to difficult symptoms that are collectively referred to as the genitourinary syndrome of menopause (GSM), according to the study.

This condition is underdiagnosed, although it can affect a woman’s well-being and sexual function. According to the study authors, breast cancer survivors are especially likely to experience GSM because of the effects of chemotherapy or endocrine therapy used to treat cancer. Because of this, the authors said health care providers must begin addressing GSM as part of survivorship care in this patient population.

Furthermore, treatment options are more limited for women with breast cancer because there are concerns about the use of even low-dose vaginal hormone therapies. The study authors found that functional CO2 laser therapy may offer a new, nonhormone treatment approach to remodel vulvar and vaginal tissues.

According to the investigators, early results suggest that the procedure is safe and effective. In the new study, CO2 laser therapy appears to have reduced sexual function problems at the 4-week follow-up visit, including in the areas of desire, arousal, lubrication, orgasm, satisfaction, and pain.

At the 4-week follow-up, additional improvements were observed in women’s interest in sex and levels of sexual activity. Although sexual function scores were lower at 1 year than at 4 weeks and indicated that women continued to experience some sexual problems, they remained significantly better than at baseline. Follow-up will be conducted again in 2 years to better identify the long-term efficacy of laser therapy.

The study authors acknowledged that their study was small, but said it provides valuable insights for health care providers treating postmenopausal women, especially those who are survivors of breast cancer. More large-scale studies will be needed in order to fully explore the long-term potential of fractional CO2 laser therapy for the treatment of GSM and associated sexual problems.

“This study highlights the issue of sexual dysfunction affecting most survivors of breast cancer and the potential role for CO2 laser therapy in the treatment of GSM and related sexual problems,” said Stephanie Faubion, MD, MBA, NAMS medical director and one of the study authors, in a statement. “Additional study is needed to better understand the long-term safety and efficacy of this therapy.”

REFERENCE
Fractional CO2 Laser Therapy Helps Improve Sexual Function in Postmenopausal Women With Breast Cancer [news release]. NAMS; February 3, 2021. https://www.menopause.org/docs/default-source/press-release/co2-laser-therapy-improves-sexual-function-in-breast-cancer-survivors-2-3-21.pdf. Accessed February 4, 2021.