Laser treatment for the management of genitourinary syndrome of menopause after breast cancer. Hope or hype?
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Introduction and hypothesis
Fractional CO2 and vaginal erbium lasers have emerged as potential treatment options for genitourinary syndrome of menopause (GSM) in breast cancer (BC) survivors.
We conducted a systematic review of the literature to ascertain whether available evidence supports the efficacy and safety of laser treatment for GSM in BC patients. MEDLINE, Scopus and Cochrane Library databases were systematically searched from inception until March 2019 for studies on laser treatment for GSM in BC patients.
We yielded six observational studies meeting the inclusion criteria. The studies were of moderate quality. Taken together, the studies suggest that laser treatment may significantly alleviate or resolve the GSM-related symptoms and improve sexual function. Furthermore, a significant increase of the vaginal health index was reported. Positive effect was maintained up to 12 months. The safety and tolerability profile is encouraging, given that no adverse effects were reported, while only few patients discontinued laser treatment, owing to reported discomfort.
Our findings suggest that lasers appear to be effective and practical treatment options in BC survivors suffering from GSM. Evidence concerning long-term effects is lacking. The rationale for repeated treatment remains uncertain. Randomized controlled trials that collate different frequencies, intensities and durations are warranted to ascertain a dose-response relationship and adherence.
KeywordsGenitourinary syndrome of menopause Vaginal atrophy Laser Breast cancer
We certify that no party has a direct interest in the results of the research and that no benefit will be conferred to us or any organization with which we are associated.
Compliance with ethical standards
Conflicts of interest
Details of ethics approval
None needed, as this is a systematic review.
- 2.Howlade N, Noone AM, Krapcho M, et al. SEER cancer statistics review, 1975–2008. Bethesda: National Cancer Institute; 2011.Google Scholar
- 11.Faubion SS, Stuenkel CA, Chism LA, et al. Management of genitourinary syndrome of menopause in women with or at high risk for breast cancer: consensus recommendations from the North American Menopause Society and the International Society for the Study of Women’s. Sexual Health Menopause. 2018;25:596–608.PubMedGoogle Scholar
- 12.ACOG Committee Opinion No. 659: the use of vaginal estrogen in women with history of estrogen-dependent breast cancer. Obstet Gynecol. 2016;127:93–96.Google Scholar
- 18.Gittens P, Mullen G. The effects of fractional microablative CO2 laser therapy on sexual function in postmenopausal women and women with a history of breast cancer treated with endocrine therapy. J Cosmet Laser Ther. 2018;8:1–5.Google Scholar
- 28.Flint R, Cardoso T, Grigoriadis T, Rantell A, Pitsouni E, Athanasiou S. Rationale and design for fractional microablative CO2 laser versus non-ablative erbium : YAG laser for the treatment of genitourinary syndrome of menopause: a non-inferiority, single-blind randomized controlled trial. Climacteric. 2019;24:1–5.Google Scholar