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Review of non-invasive vulvovaginal rejuvenation.
J Eur Acad Dermatol Venereol. 2020 Apr; 34(4):716-726.JE

Abstract

Vulvovaginal atrophy (VVA) or genitourinary syndrome of menopause (GSM) may affect up to 90% of menopausal women. Features include vulvovaginal atrophy, vulvovaginal laxity, vulvovaginal dryness and irritation, dyspareunia, anorgasmia and urinary symptoms. The vulva, vagina and bladder are oestrogen-responsive tissues, but oestrogen replacement therapy is not possible in women who have hormone-responsive cancers or normal oestrogen levels. Therefore, there is a role for alternative treatments. To date, three non-surgical energy-based therapies have been proposed: fractional microablative CO2 laser, erbium:YAG laser and temperature-controlled radiofrequency (RF). Our objective was to assess the available evidence for the safety and efficacy of erbium:YAG laser, microablative fractional CO2 laser and RF in the treatment of VVA/GSM. The authors reviewed the current published literature evaluating these therapies. All three therapies appear safe; however, all the studies were uncontrolled and used different protocols and outcome measurements. Therefore, comparison of treatments is difficult. It appears that there is more evidence in favour of the CO2 laser than the erbium:YAG laser. Both lasers have more evidence than RF. In conclusion, microablative CO2 laser, erbium:YAG laser and RF may be offered to patients suffering from VVA/GSM as an alternative or adjunct to conventional therapies. Further well-conducted controlled studies are needed.

Authors+Show Affiliations

Department of Dermatology, The Alfred Hospital, Melbourne, Vic., Australia.Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31714632

Citation

Photiou, L, et al. "Review of Non-invasive Vulvovaginal Rejuvenation." Journal of the European Academy of Dermatology and Venereology : JEADV, vol. 34, no. 4, 2020, pp. 716-726.
Photiou L, Lin MJ, Dubin DP, et al. Review of non-invasive vulvovaginal rejuvenation. J Eur Acad Dermatol Venereol. 2020;34(4):716-726.
Photiou, L., Lin, M. J., Dubin, D. P., Lenskaya, V., & Khorasani, H. (2020). Review of non-invasive vulvovaginal rejuvenation. Journal of the European Academy of Dermatology and Venereology : JEADV, 34(4), 716-726. https://doi.org/10.1111/jdv.16066
Photiou L, et al. Review of Non-invasive Vulvovaginal Rejuvenation. J Eur Acad Dermatol Venereol. 2020;34(4):716-726. PubMed PMID: 31714632.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Review of non-invasive vulvovaginal rejuvenation. AU - Photiou,L, AU - Lin,M J, AU - Dubin,D P, AU - Lenskaya,V, AU - Khorasani,H, Y1 - 2019/12/05/ PY - 2019/07/02/received PY - 2019/10/17/accepted PY - 2019/11/13/pubmed PY - 2021/1/30/medline PY - 2019/11/13/entrez SP - 716 EP - 726 JF - Journal of the European Academy of Dermatology and Venereology : JEADV JO - J Eur Acad Dermatol Venereol VL - 34 IS - 4 N2 - Vulvovaginal atrophy (VVA) or genitourinary syndrome of menopause (GSM) may affect up to 90% of menopausal women. Features include vulvovaginal atrophy, vulvovaginal laxity, vulvovaginal dryness and irritation, dyspareunia, anorgasmia and urinary symptoms. The vulva, vagina and bladder are oestrogen-responsive tissues, but oestrogen replacement therapy is not possible in women who have hormone-responsive cancers or normal oestrogen levels. Therefore, there is a role for alternative treatments. To date, three non-surgical energy-based therapies have been proposed: fractional microablative CO2 laser, erbium:YAG laser and temperature-controlled radiofrequency (RF). Our objective was to assess the available evidence for the safety and efficacy of erbium:YAG laser, microablative fractional CO2 laser and RF in the treatment of VVA/GSM. The authors reviewed the current published literature evaluating these therapies. All three therapies appear safe; however, all the studies were uncontrolled and used different protocols and outcome measurements. Therefore, comparison of treatments is difficult. It appears that there is more evidence in favour of the CO2 laser than the erbium:YAG laser. Both lasers have more evidence than RF. In conclusion, microablative CO2 laser, erbium:YAG laser and RF may be offered to patients suffering from VVA/GSM as an alternative or adjunct to conventional therapies. Further well-conducted controlled studies are needed. SN - 1468-3083 UR - https://www.unboundmedicine.com/medline/citation/31714632/Review_of_non_invasive_vulvovaginal_rejuvenation_ L2 - https://doi.org/10.1111/jdv.16066 DB - PRIME DP - Unbound Medicine ER -