MON-207 Evaluating Microablative Radiofrequency For GSM In Postmenopausal Women: A Systematic Review

Disclosure: Y.D. Moura: None. J. Panzan: None. C.A. dos Reis: None. S.S. de Afonseca: None. J.M. Ferreira: None. J.A. de Oliveira: None. D.D. Miguel: None. V.A. Pinheiro: None. R.P. Bolzani: None. D. Rodrigues: None. G. Bifulco Soares: None. M.G. Pereira: None. L.H. Graciolli: None. Introduction: The Genitourinary Syndrome of Menopause (GSM) encompasses a set of symptoms resulting from decreased estrogen and other steroid hormones, affecting up to 80% of postmenopausal women. Common symptoms include dyspareunia, dysuria, and vaginal dryness, which significantly impact quality of life. New therapies such as microablative radiofrequency (RFMA) and CO₂ laser have emerged as promising alternatives to traditional hormonal treatments. Methods: A systematic review was conducted using the PubMed, Embase and Cochrane databases, selecting randomized clinical trials from the last five years. Three RCTs were included, analyzing a total of 156 postmenopausal women. Interventions compared RFMA, topical promestriene, and fractional CO₂ laser, with outcomes assessed through the Vaginal Health Index (VHI) and the Female Sexual Function Index (FSFI). All studies adhered to histological safety protocols, including pre- and post-treatment biopsies in some cohorts. Results: All three interventions resulted in significant improvement in GSM symptoms and VHI scores, with no adverse histological findings. RFMA showed the most substantial improvements in sexual function, with one trial reporting a 146.1% increase in FSFI total score after 4 months. Improvements in desire (+1.32), arousal (+2.37), and orgasm (+2.8) domains were significant only in the RFMA group (p < 0.01). In breast cancer survivors under adjuvant endocrine therapy, RFMA and CO₂ laser were as effective as promestriene, with no clinical or histological damage reported. These findings highlight the efficacy and safety of RFMA, especially for women contraindicated for hormonal therapy. Conclusion: RFMA is a safe and effective alternative for managing GSM in postmenopausal women, particularly those with contraindications to hormone therapy. Its superior outcomes in sexual function domains and absence of tissue damage suggest its potential as a first-line non-hormonal therapy. Further long-term studies are warranted to validate these results and assess durability over time. Presentation: Monday, July 14, 2025