Yonsei Medical Journal · Dec 23, 2025

Management of Genitourinary Syndrome of Menopause in Korean Breast Cancer Survivors by Fractional CO₂ Laser Treatment

By Chung YJ, Ko M, Park JY et al.

PURPOSE: Many breast cancer patients experience genitourinary syndrome of menopause (GSM) symptoms. Concerns about systemic absorption limit the use of local estrogen therapy, and clinicians are often hesitant to prescribe it to breast cancer survivors. Therefore, other treatment options are essential. The aim of this study was to examine the safety and effectiveness of fractional CO₂ laser treatment in breast cancer survivors experiencing GSM. MATERIALS AND METHODS: Each woman received three fractional CO₂ treatments at 4-week intervals between sessions: baseline (V1), 4-week follow-up (V2), 8-week follow-up (V3), and a final follow-up at 12 weeks (V4). Breast cancer survivors who had one or more symptoms related to GSM qualified for inclusion in this study. Severity of symptoms was assessed with a visual analog scale (VAS) at baseline and every follow-up visit. We also measured GSM objectively using the vaginal health index score (VHIS) at every visit. At V4, patients evaluated their satisfaction with laser therapy using a 5-point Likert scale. RESULTS: Twenty-four women were included in the study. Almost all symptoms showed improvement based on mean VAS score after treatment. Vaginal dryness and urgency improved after the second treatment. After completion of all treatments, all symptoms except frequency showed improvement. VHIS increased significantly after completion of laser treatment (8.5±3.1 at baseline vs. 16.2±2.9 at V4; p<0.001). CONCLUSION: Fractional CO₂ laser treatment appears to be an effective and safe method in breast cancer survivors with GSM.

doi.org/10.3349/ymj.2025.0161 Open access PubMed 41431412 Interventions