Fractional Carbon Dioxide Laser Therapy Compared to Ospemifene in the Treatment of Vaginal Atrophy in Menopause.

Abstract

During the menopausal transition, women often experience an array of symptoms, including vaginal dryness, itching, pain, burning, decreased sexual desire, and inadequate lubrication, which are all due to hormonal changes called hypoestrogenism. Hypoestrogenism simply means a low level of estrogen which turn leads to a constellation of symptoms including hot flashes, urinary tract infections, decreased bone density and sleep disturbances. Some women find these symptoms embarrassing not to seek help, while some take it as a natural process of aging. Although various researchers have established different treatments in the past, such as lubricants and moisturizers, newer therapies such as fractional carbon dioxide (CO2) laser therapy and a selective estrogen receptor modulator ospemifene are currently being used and yet still researched. To highlight the lack of research on this topic, our article search involving only the PubMed database yielded 175 articles initially, but after exclusion and inclusion criteria, we were left with only 32 studies directly related to our research topic. Our study included English articles, full-text articles, articles on human studies, and articles from 2005-2020. We excluded all studies prior to 2005, animal studies, pediatrics study, and only abstract study. All articles were chosen without limitation to the type of study. Our review suggests that patients often present with various symptoms and severity based on histology, mechanisms, and clinical findings. Therefore, treatment should be personalized. Our study aimed to further understand a better treatment option for vulvovaginal atrophy (VVA) in postmenopausal women, knowing that menopause is an inevitable stage of a woman's life.