Aya Mohamed Nasr, Mohab Alsaid Saad, Amer Salah Mohamed, Yousif Ahmad Hanafi, Bilal Walid Bazbaz, Sarra Salah Amer Mohamed, Sayed Mahmoud Selim, Zaid Fatehi Altawallbeh
{"title":"CO2激光与阴道雌激素对围绝经期妇女伴绝经期泌尿生殖系统综合征的疗效：系统评价和meta分析。","authors":"Aya Mohamed Nasr, Mohab Alsaid Saad, Amer Salah Mohamed, Yousif Ahmad Hanafi, Bilal Walid Bazbaz, Sarra Salah Amer Mohamed, Sayed Mahmoud Selim, Zaid Fatehi Altawallbeh","doi":"10.1093/jsxmed/qdaf153","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Genitourinary syndrome of menopause (GSM) is characterized by vaginal dryness, itching, burning, pain during intercourse, and urinary symptoms. Traditionally, hormone replacement therapy (HRT), specifically estrogen therapy, has been the first-line treatment for GSM, due to its side effects, fractional CO2 laser therapy has emerged as an alternative for managing GSM symptoms.</p><p><strong>Aim: </strong>The primary focus is to compare CO2 fractional laser therapy and estrogen therapy on postmenopausal women with GSM through systemically reviewing all the randomized controlled trials.Methods: A comprehensive search of electronic databases, including PubMed, Scopus, Web of Science, Medline, Cochrane, Scielo, UC Berkeley library, and Google Scholar, was performed in October 2024. The inclusion criteria targeted randomized controlled trials comparing CO2 fractional laser therapy and estrogen therapy on postmenopausal women with GSM, which used at least 1 of these outcomes: Female Sexual Function Index (FSFI), Vaginal Health Index, Visual Analog Score, and Urinary Distress Inventory 6.</p><p><strong>Results: </strong>Out of 688 studies, 7 studies were included for final analysis with a total of 302 participants: 154 had CO2 fractional laser therapy with a mean age of 55.9 years, and 148 had estrogen therapy with a mean age of 57.2 years. The analysis revealed no statistically significant difference between CO2 laser and estrogen in Vaginal Health Index (mean difference [MD], 1.60; 95% CI, -0.36 to 3.56; P = .09), FSFI-total (MD, 0.10; 95% CI, -2.03 to 2.23; P = .93), and Urinary Distress Inventory 6 (MD, -3.18; 95% CI, -6.77 to 0.42; P = .08). We used a sensitivity analysis on the FSFI-arousal subscale due to high heterogeneity, excluding 1 study. It showed that the CO2 laser group had a statistically significant difference when compared with the estrogen group (MD, 0.47; 95% CI, 0.15-0.79; P = .01).</p><p><strong>Conclusion: </strong>CO2 laser therapy is an effective line of treatment for GSM. However, its comparison with estrogen therapy did not reach a statistically significant difference favoring one line over the other.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of CO2 laser vs vaginal estrogen in perimenopausal women with genitourinary syndrome of menopause: systematic review and meta-analysis.\",\"authors\":\"Aya Mohamed Nasr, Mohab Alsaid Saad, Amer Salah Mohamed, Yousif Ahmad Hanafi, Bilal Walid Bazbaz, Sarra Salah Amer Mohamed, Sayed Mahmoud Selim, Zaid Fatehi Altawallbeh\",\"doi\":\"10.1093/jsxmed/qdaf153\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Genitourinary syndrome of menopause (GSM) is characterized by vaginal dryness, itching, burning, pain during intercourse, and urinary symptoms. Traditionally, hormone replacement therapy (HRT), specifically estrogen therapy, has been the first-line treatment for GSM, due to its side effects, fractional CO2 laser therapy has emerged as an alternative for managing GSM symptoms.</p><p><strong>Aim: </strong>The primary focus is to compare CO2 fractional laser therapy and estrogen therapy on postmenopausal women with GSM through systemically reviewing all the randomized controlled trials.Methods: A comprehensive search of electronic databases, including PubMed, Scopus, Web of Science, Medline, Cochrane, Scielo, UC Berkeley library, and Google Scholar, was performed in October 2024. The inclusion criteria targeted randomized controlled trials comparing CO2 fractional laser therapy and estrogen therapy on postmenopausal women with GSM, which used at least 1 of these outcomes: Female Sexual Function Index (FSFI), Vaginal Health Index, Visual Analog Score, and Urinary Distress Inventory 6.</p><p><strong>Results: </strong>Out of 688 studies, 7 studies were included for final analysis with a total of 302 participants: 154 had CO2 fractional laser therapy with a mean age of 55.9 years, and 148 had estrogen therapy with a mean age of 57.2 years. The analysis revealed no statistically significant difference between CO2 laser and estrogen in Vaginal Health Index (mean difference [MD], 1.60; 95% CI, -0.36 to 3.56; P = .09), FSFI-total (MD, 0.10; 95% CI, -2.03 to 2.23; P = .93), and Urinary Distress Inventory 6 (MD, -3.18; 95% CI, -6.77 to 0.42; P = .08). We used a sensitivity analysis on the FSFI-arousal subscale due to high heterogeneity, excluding 1 study. It showed that the CO2 laser group had a statistically significant difference when compared with the estrogen group (MD, 0.47; 95% CI, 0.15-0.79; P = .01).</p><p><strong>Conclusion: </strong>CO2 laser therapy is an effective line of treatment for GSM. 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Efficacy of CO2 laser vs vaginal estrogen in perimenopausal women with genitourinary syndrome of menopause: systematic review and meta-analysis.
Background: Genitourinary syndrome of menopause (GSM) is characterized by vaginal dryness, itching, burning, pain during intercourse, and urinary symptoms. Traditionally, hormone replacement therapy (HRT), specifically estrogen therapy, has been the first-line treatment for GSM, due to its side effects, fractional CO2 laser therapy has emerged as an alternative for managing GSM symptoms.
Aim: The primary focus is to compare CO2 fractional laser therapy and estrogen therapy on postmenopausal women with GSM through systemically reviewing all the randomized controlled trials.Methods: A comprehensive search of electronic databases, including PubMed, Scopus, Web of Science, Medline, Cochrane, Scielo, UC Berkeley library, and Google Scholar, was performed in October 2024. The inclusion criteria targeted randomized controlled trials comparing CO2 fractional laser therapy and estrogen therapy on postmenopausal women with GSM, which used at least 1 of these outcomes: Female Sexual Function Index (FSFI), Vaginal Health Index, Visual Analog Score, and Urinary Distress Inventory 6.
Results: Out of 688 studies, 7 studies were included for final analysis with a total of 302 participants: 154 had CO2 fractional laser therapy with a mean age of 55.9 years, and 148 had estrogen therapy with a mean age of 57.2 years. The analysis revealed no statistically significant difference between CO2 laser and estrogen in Vaginal Health Index (mean difference [MD], 1.60; 95% CI, -0.36 to 3.56; P = .09), FSFI-total (MD, 0.10; 95% CI, -2.03 to 2.23; P = .93), and Urinary Distress Inventory 6 (MD, -3.18; 95% CI, -6.77 to 0.42; P = .08). We used a sensitivity analysis on the FSFI-arousal subscale due to high heterogeneity, excluding 1 study. It showed that the CO2 laser group had a statistically significant difference when compared with the estrogen group (MD, 0.47; 95% CI, 0.15-0.79; P = .01).
Conclusion: CO2 laser therapy is an effective line of treatment for GSM. However, its comparison with estrogen therapy did not reach a statistically significant difference favoring one line over the other.
期刊介绍：
The Journal of Sexual Medicine publishes multidisciplinary basic science and clinical research to define and understand the scientific basis of male, female, and couples sexual function and dysfunction. As an official journal of the International Society for Sexual Medicine and the International Society for the Study of Women''s Sexual Health, it provides healthcare professionals in sexual medicine with essential educational content and promotes the exchange of scientific information generated from experimental and clinical research.
The Journal of Sexual Medicine includes basic science and clinical research studies in the psychologic and biologic aspects of male, female, and couples sexual function and dysfunction, and highlights new observations and research, results with innovative treatments and all other topics relevant to clinical sexual medicine.
The objective of The Journal of Sexual Medicine is to serve as an interdisciplinary forum to integrate the exchange among disciplines concerned with the whole field of human sexuality. The journal accomplishes this objective by publishing original articles, as well as other scientific and educational documents that support the mission of the International Society for Sexual Medicine.
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