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The use of pulsed CO2 lasers for the treatment of vulvovaginal atrophy

Stefano, Salvatorea; Stavros, Athanasioub; Massimo, Candiania

Current Opinion in Obstetrics and Gynecology: December 2015 - Volume 27 - Issue 6 - p 504–508
doi: 10.1097/GCO.0000000000000230

Purpose of review This article reviews the literature regarding the safety and efficacy of the use of a pulsed CO2 laser for the treatment of vulvovaginal atrophy (VVA).

Recent findings Prospective observational studies have demonstrated histological changes after the use of pulsed CO2 laser vaginally in atrophic conditions. Increased collagen and extracellular matrix production has been reported together with an increase in the thickness of the vaginal epithelium with the formation of new papilla. Three different observational studies reported a significant improvement of VVA assessed subjectively (with a 10-point visual analogue scale) and objectively (using the Vaginal Health Index) after a cycle of three treatments of pulsed CO2 laser. Also sexual function (assessed with the Female Sexual Function Index) and quality of life (evaluated with the SF12 questionnaire) significantly improved. No complications or side-effects were reported during or after the laser procedure that was performed in an outpatient setting.

Summary Increasing evidence with histological and clinical data supports the use of pulsed CO2 lasers in the treatment of VVA; however, no randomized control trial (sham versus treatment) has yet been produced and no data on the duration of therapy are currently available.

aObstetrics and Gynecology Unit, Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy

bUrogynecology Unit, First Department of Obstetrics and Gynecology, National & Kapodistrian University of Athens, Athens, Greece

Correspondence to Salvatore Stefano, Department of Obstetrics and Gynecology, San Raffaele Hospital, Via Olgettina 60, 20132, Milan, Italy. Tel: +39 02 26432653;+39 347 2757131; fax: +39 02 26432759; e-mail:

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