Gynecologie, Obstetrique, Fertilite & Senologie · Jan 21, 2026

Clinical and histological evaluation of fractional CO₂ laser treatment for genitourinary syndrome of menopause

By Le Bris D, Devalland C, Puyraveau M et al.

OBJECTIVE: To analyze the clinical and cyto-histological evolution of Genitourinary Syndrome of Menopause (GSM) with the use of fractional carbon dioxide laser. METHODS: We conducted a prospective clinical trial at the Hôpital Nord Franche-Comté, Trévenans, France, over a period of 19 months from 2022 to 2023. The patients enrolled were women over 40 years old, postmenopausal with vaginal symptoms of GSM. The primary outcome was the comparison of the clinical symptom intensity score before and after the three laser sessions. The secondary outcomes were the evolution of GSM with laser treatment through a clinical score, a medical score, the assessment of the sexual quality of life, the study of the cytological and histological effects of the laser, and its side effects. RESULTS: Among the 75 patients enrolled, 68 have been studied. There was a significant improvement of all the symptoms, the medical score and the sexual quality of life after three laser sessions (P<0.01). In cytology, there was an improvement in the vaginal maturation value with an increase in superficial cells and a decrease in basal cells (P<0.01). Histologically, there was an increase in the thickness of the epithelium (P<0.01), the size of the epithelial cells (P=0.01), and the glycogen (P<0.01), and a decrease in the thickness of the basal layers (P<0.01). CONCLUSION: Fractional carbon dioxide laser improves symptoms of GSM, sexual quality of life and restores the characteristics of the vaginal epithelium with effects still present six months after.

doi.org/10.1016/j.gofs.2026.01.009 Open access PubMed 41577253 Interventions