Vaginal CO2 Laser Versus Topical Estriol Treatment for Vaginal Atrophy in Postmenopausal Women: 1-Year Follow-up [20P]

INTRODUCTION: Vulvovaginal atrophy (VVA) affects up to 50% of postmenopausal women with great impact on quality of life and sexual function. Vaginal CO2 laser is a promising therapeutic, but its long-term efficacy is unknown. METHODS: 45 postmenopausal women were randomized in 3 groups on a double-blind, placebo-controlled study: L group (vaginal fractional CO2 laser), E group (topical Estriol), or LE group (combination of both). Assessments at 12 weeks (week 20) and 1-year after treatment completion were conducted using Vaginal Health Index (VHI), Visual Analog Scale for VVA symptoms (dyspareunia, dryness, and burning), Female Sexual Function Index (FSFI), and maturation value of Meisels. RESULTS: Of the 45 women, 6 were lost to follow-up at 1-year. No adverse effects were reported throughout the study. The average VHI score was significantly higher at week 20 in all study arms. VHI scores and symptoms of dyspareunia, dryness and burning were similar at week 20 and 1-year (p=0.59) in the L group. Both estrogen treated groups with and without combined laser had significant lower VHI scores (p=0.02 and p=0.0001, respectively) and worsening symptoms of hydration and burning when compared to week 20. Patient perception of symptoms on FSFI was similar in all study arms at week 20 and 1-year (p=0.5). CONCLUSION: Improvement of VVA symptoms persisted 1-year after fractional CO2 treatment. Outcomes of Estriol therapy alone or associated with laser were not maintained 1-year after treatment, although estriol remains a safe treatment option for VVA symptoms.