GSM or VVA represents a constellation of symptoms [5] that, although underreported, has been estimated to affect up to 50% of postmenopausal women [6] and affects quality of life [7], [8] as a result of the natural decrease of estrogen levels after the onset of menopause (naturally or iatrogenic). Before menopause, with normal circulating levels of endogenous estrogen, vaginal canal physiology is characterized by the presence of a thickened, rugated, nonkeratinized epithelial layer that is well
The symptoms of GSM/VVA commonly include, but are not limited to, reductions in the diameter and elasticity of the introitus and internal vaginal canal, thinning of vaginal tissues, and loss of natural lubrication, which often leads to the secondary effects of dryness, itching, irritation, dyspareunia, sexual dysfunction, and dysuria. Stretching and trauma to the vaginal tissues from normal aging, maternity, and childbirth can cause not only functional changes of lack of support to the vagina,
Traditional nonsurgical methods targeted to the vaginal tissues themselves for functional improvement of symptomatic GSM/VVA/VRS include nonhormonal vaginal lubricants, continued sexual activity, and local and systemic estrogen, or estrogen modulator (Ospemifene) therapy. Traditional nonsurgical methods of treating symptoms resulting from the laxity and loss of support of the deeper vaginal tissues include Kegel exercises, bladder training, overactive bladder medications, and the wearing of
Among the new nonsurgical modalities being offered to female rejuvenation patients are lasers and RF devices, which target the vaginal connective tissues, and the newest device, which uses electromagnetic therapy that targets muscle.
Lasers, or “light amplification by stimulated emission of radiation,” employ wavelengths that are selected in order to target a specific tissue chromophore, such as water in the vaginal tissues [17]. Selective photothermolysis describes the desirable clinical effect
The CO2 laser emits light at a wavelength of 10,600 nm, which is strongly absorbed by tissue water [18]. With fractional CO2 devices, an array of microbeams of laser light is delivered to create microscopic columns of energy-mediated effects using either optical scanners to deliver the spot or a stamping technique [20]. The microscopic lesions extend from the vaginal epithelium into the lamina propria, to depths dictated by laser energy density and spot size. The evolution of this technology
There are 4 main types of UI, the involuntary leakage of urine:
Stress urinary incontinence (SUI) is the most common variety, and it is also the most amenable to improvement with nonsurgical vaginal
The plethora of data being generated from the large number of publications in peer-reviewed journals on cell activation and vaginal wall rejuvenation after the use of light and energy-based devices is encouraging. There seems to be firm consensus that these devices are indeed effective in treating GSM-related symptoms, rejuvenating intimate female anatomy, and restoring a sense of female intimate wellness for many women after childbirth and menopause. The currently available data on the effects
