Ospemifene plus fractional CO₂ laser: a powerful strategy to treat postmenopausal vulvar pain

Abstract

This study is a single-center, retrospective analysis of postmenopausal women presenting with dyspareunia and vulvar pain, aiming to evaluate relative effectiveness of vestibular CO₂ laser therapy as a treatment. Three monthly sessions of laser were performed to each patient and thereafter a three-months follow-up was stablished. A total number of 72 patients undergoing vestibular laser treatment were recruited from patient files in the period between 2016 and 2018. Among these, 39 women also received a concomitant treatment with ospemifene (60 mg/day) during the study period. There was a statistically significant reduction of all the symptoms in both groups up to the three month follow-up. Regarding dryness and dyspareunia, the relief tent to be more prominent in the ospemifene + laser group at all follow-ups and remained statistically significant at three-month follow-up. Specifically, vestibular dryness was significantly lower in the ospemifene + laser group compared with the laser treatment group (−87% vs − 34%, respectively), and the vestibular health score started declining faster in the ospemifene + laser group. Although, additional research is needed to understand the mechanism of action, our data shows that a combination regimen of laser and ospemifene may improve clinical effectiveness for long-term treatment of symptoms associated with the under-recognized genitourinary syndrome of menopause.

摘要

本研究是一项单中心, 对表现为性交困难和外阴疼痛的绝经后女性进行回顾性分析, 旨在评价前庭CO2激光治疗的相对疗效。每个患者每月接受三次激光治疗, 然后进行为期三个月的随访。筛选出了72名2016年至2018年接受前庭激光治疗的患者, 其中39名女性在研究期间还同时接受了奥培米芬（60mg/天）的治疗。在三个月的随访中, 两组患者的所有症状在统计上都有显著降低。关于前庭干燥和性交困难, 奥培米芬激光组患者的缓解更为明显, 并且在三个月的随访中仍然具有统计学意义。与激光治疗组相比, 奥培米芬激光组前庭干燥明显降低（分别为-87%和-34%）, 并且前庭健康评分开始下降速度更快。虽然还需要更多的研究来了解作用机制, 但我们的数据表明, 激光和奥培米芬的联合方案可能会改善认识不足的更年期泌尿生殖系统综合征相关症状长期治疗的临床有效性。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• genitourinary syndrome of menopause
• vulvar and vaginal atrophy
• vestibular CO2 laser therapy
• ospemifene
• dyspareunia
• vulvar pain

Disclosure statement

The authors reported no conflicts of interest relevant to the study.

Additional information

Funding

Medical writing editorial support was provided by Trial Form Support, with financial support provided by Shionogi Ltd.