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Introduction and Hypothesis <p>To evaluate the short- and long-term clinical outcomes of fractional CO<sub>2</sub> laser therapy in postmenopausal women with genitourinary syndrome of menopause (GSM), including durability of symptom control and the need for booster sessions.</p> Methods <p>This retrospective single-center study included 126 postmenopausal women with GSM who underwent a standardized three-session fractional CO<sub>2</sub> laser protocol. Booster sessions were applied in cases of symptom recurrence. Outcomes were assessed at baseline, 4–6&#xa0;weeks, 1&#xa0;year, and 2&#xa0;years using validated instruments: Patient Satisfaction Score, Michigan Incontinence Severity Index (MISI), Female Sexual Function Index (FSFI) and its subdomains, Vulvovaginal Symptoms Questionnaire (VSQ), and Female Genital Self-Image Scale (FGSIS).</p> Results <p>Significant improvement was observed in all outcome measures at 4–6&#xa0;weeks, including GSM-related symptoms, sexual function, and genital self-image (all <i>p</i> &lt; 0.0001). These benefits were largely sustained at 1 year. Although a slight decline was noted at 2 years, scores remained significantly improved compared to baseline. For example, FSFI lubrication scores improved from 2.97 ± 0.55 at baseline to 4.54 ± 0.49 at 1 year, and both VSQ and FGSIS demonstrated persistent gains at 2 years. Satisfaction scores continued to increase over time. Post hoc analyses confirmed significant differences across all evaluation time points.</p> Conclusion <p>Fractional CO<sub>2</sub> laser therapy provides clinically meaningful and durable improvement in GSM-related symptoms in postmenopausal women. While some decline may occur over time, benefits remain superior to baseline, and booster sessions may support long-term maintenance. Fractional CO<sub>2</sub> laser may represent a nonhormonal, symptom-oriented option for carefully selected patients with GSM; however, it should not be considered first-line therapy, and prospective controlled studies are needed to further define long-term efficacy and patient selection.</p>

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Two-Year Real-World Outcomes in Women with Genitourinary Syndrome of Menopause Following Fractional CO2 Laser Treatment

  • 期刊论文

  • 发表日期：

    2026年5月16日

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  • Telal Dogruel,
  • Pinar Kadirogullari,
  • Hikmet Can Dogruel,
  • Umran Karabulut Dogan,
  • Erhan Huseyin Comert,
  • Ozan Dogan

摘要

Introduction and Hypothesis

To evaluate the short- and long-term clinical outcomes of fractional CO2 laser therapy in postmenopausal women with genitourinary syndrome of menopause (GSM), including durability of symptom control and the need for booster sessions.

Methods

This retrospective single-center study included 126 postmenopausal women with GSM who underwent a standardized three-session fractional CO2 laser protocol. Booster sessions were applied in cases of symptom recurrence. Outcomes were assessed at baseline, 4–6 weeks, 1 year, and 2 years using validated instruments: Patient Satisfaction Score, Michigan Incontinence Severity Index (MISI), Female Sexual Function Index (FSFI) and its subdomains, Vulvovaginal Symptoms Questionnaire (VSQ), and Female Genital Self-Image Scale (FGSIS).

Results

Significant improvement was observed in all outcome measures at 4–6 weeks, including GSM-related symptoms, sexual function, and genital self-image (all p < 0.0001). These benefits were largely sustained at 1 year. Although a slight decline was noted at 2 years, scores remained significantly improved compared to baseline. For example, FSFI lubrication scores improved from 2.97 ± 0.55 at baseline to 4.54 ± 0.49 at 1 year, and both VSQ and FGSIS demonstrated persistent gains at 2 years. Satisfaction scores continued to increase over time. Post hoc analyses confirmed significant differences across all evaluation time points.

Conclusion

Fractional CO2 laser therapy provides clinically meaningful and durable improvement in GSM-related symptoms in postmenopausal women. While some decline may occur over time, benefits remain superior to baseline, and booster sessions may support long-term maintenance. Fractional CO2 laser may represent a nonhormonal, symptom-oriented option for carefully selected patients with GSM; however, it should not be considered first-line therapy, and prospective controlled studies are needed to further define long-term efficacy and patient selection.