Efficiency of combined treatment of genitourinary menopausal syndrome

Abstract

DOI: 10.52705/2788-6190-2026-03-9
УДК 618.173-008.6-059-036.8

The objective: to prove the effectiveness of using a fractional vaginal CO2 laser as an adjunctive method of treatment for women with genitourinary syndrome of menopause (GSM).
Materials and methods. The study involved 52 women aged 48 to 69 years. All women had complaints characteristic of genitourinary syndrome: vaginal dryness, dyspareunia, stress urinary incontinence. All women were divided into two groups: Group 1 included 34 women who received only local therapy with vaginal estrogen suppositories; Group 2 included 18 women who, in addition to local vaginal estrogen therapy, underwent an additional course of three procedures of vaginal fractional
CO2 laser rejuvenation. In both groups, the course of vaginal estrogen therapy consisted of 1 month of daily use and another two months of maintenance therapy (using suppositories twice a week). Women in the second group received a course of three procedures of vaginal fractional CO2 laser rejuvenation during the two months of maintenance therapy with an interval of 21 days between procedures.
Results. In the group of women who received only local vaginal estrogen therapy, a decrease in vaginal dryness was noted by 32 (94.1 %) women, a decrease in dyspareunia phenomena was noted by 22 (64.7 %) women, and a decrease in stress urinary incontinence occurred in 10 (29.4%) women. In the group of women who additionally received a course of laser vaginal rejuvenation, a decrease in symptoms of vaginal dryness was noted by 18 (100%) women, a decrease in dyspareunia was noted by 16 (88.9 %) women, and a decrease in stress urinary incontinence phenomena occurred in 12 (66.7 %) women. Upon comparative analysis of the obtained results, it was established that the combination of using vaginal estrogen-containing suppositories with conducting a course of vaginal fractional CO2 laser rejuvenation yields better results in reducing the clinical symptoms of GSM. At the same time, the effectiveness of the combined therapy in reducing vaginal dryness was only 1.06 times higher compared to therapy with vaginal suppositories alone. However, the effectiveness of the combined therapy in reducing the phenomena of dyspareunia and stress urinary incontinence was 1.37 and 2.27 times higher, respectively.
Conclusions. The results obtained by us make it possible to select the optimal therapy for women with GSM depending on the dominant clinical symptom.