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November 5, 2021 - Vaginal "rejuvenation" therapy has become big business, as evidenced by Internet searches that bring up long lists of local practitioners who advertise these services. A popular treatment is the use of lasers that are supposed to "reverse vaginal atrophy and relieve symptoms like vaginal pain, dryness, and urinary incontinence," leading to "improved sexual functioning and cosmetic appearance."

The lasers are emitted from a wand that is inserted into the vagina, and they claim to work by "penetrating the vaginal walls and stimulating collagen and elastin production deep within the vaginal tissues. Collagen and elastin remodeling begins immediately and continues for weeks, helping your vagina rebuild its elasticity while improving your body’s production of natural lubricants and balancing your pH levels." The treatments last about 5 minutes, and it is recommended that a woman undergo three sessions over the course of 18 weeks. Rejuvenating a vagina isn't cheap, and the average cost of a treatment course is about $2700.

To ensure that women are getting their money's worth, researchers in Australia performed a randomized trial that compared real laser treatments to sham treatments in 85 postmenopausal women with vaginal symptoms. The primary outcome was change in symptom severity (measured with several different questionnaires) at 12 months. Vaginal tissue samples were also taken before and after treatment from about half the women. The samples were examined under a microscope to look for a shift in histology from postmenopausal to premenopausal. At the end of the study, no significant difference was found between real laser treatments and sham treatments for any of the measures. Tissue samples also showed no difference, with 9% of laser-treated women demonstrating a shift to premenopausal histology compared to 12.5% of sham-treated women. [PubMed abstract]

Women with menopausal vaginal symptoms should stick to vaginal estrogen preparations (e.g. creams, rings, inserts) and skip the not-so-magic wand.


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