Advancing Gynecological Care with Laser Therapy: Three Notable Studies

Gaspar et al. investigated non-ablative Er:YAG laser therapy as a promising treatment for recurrent vulvovaginal candidiasis (RVVC). In a study of 167 women, four laser sessions over four months led to a significant and lasting reduction in symptoms such as burning, itching, pain during sex (dyspareunia), painful urination (dysuria), and abnormal discharge.

The results were striking: Nine months after treatment, Candida albicans prevalence dropped from 80% to 30%, with an even greater decline in asymptomatic carriers (from 63% to just 3%). Even Candida glabrata—known for its resistance to antifungal treatments—showed a significant decrease. The study also found a complete elimination of Trichomonas and Gardnerella infections, despite these not being the primary focus of the research.

Beyond pathogen reduction, patients reported dramatic symptom relief. Complete symptom resolution ranged from 38% (abnormal discharge) to 74% (dysuria), with consistent improvements observed throughout the study. Patient satisfaction was equally high: 86% of participants reported relief or great relief, increasing to 94% among those with acute vaginitis.

Most importantly, the effects weren’t short-lived. The improvements held steady at both the 3-month and 9-month follow-ups, suggesting laser therapy doesn’t just relieve symptoms—it helps restore long-term vaginal health by rebalancing the microbiome. These findings position laser therapy as an effective alternative or complementary option to traditional antifungal treatments.  

Vaginal atrophy affects over 15% of premenopausal women and half of postmenopausal women, often causing discomfort, dryness, and pain during intercourse. However, a novel laser-based treatment may provide relief. Bayraktar et al. explored the effectiveness of non-ablative Er:YAG laser therapy for atrophic vaginitis, using shear wave elastography (SWE) to objectively measure changes in vaginal tissue elasticity.

In this randomized, double-blind, sham-controlled pilot study of 20 women, three sessions of laser therapy were administered at three-week intervals, leading to statistically significant improvements in vaginal tissue elasticity, vaginal pH, and overall vaginal health compared to the control group. Vaginal pH, a key marker of vaginal health, dropped from 5.7 to 5.1 in laser-treated patients, while remaining unchanged in the sham group. Additionally, 92% of laser-treated women saw improvements in sexual function scores (FSFI), while pain during intercourse decreased significantly.

Although limited by a small sample size and short follow-up (three weeks post-treatment), this study supports Er:YAG laser therapy as a viable non-hormonal solution for postmenopausal vaginal atrophy. The findings suggest it not only relieves symptoms but also improves tissue structure and function. Additionally, SWE could be a valuable tool for clinicians to objectively track treatment progress.

Fidecicchi and Gambacciani investigated the combined use of vaginal erbium laser (VEL) and hyaluronic acid (HA) for treating genitourinary syndrome of menopause (GSM). In their randomized study, participants underwent three laser sessions, each spaced one month apart. The results revealed that adding HA to laser therapy significantly improved symptoms of vaginal dryness and dyspareunia compared to laser alone.

What makes this study particularly compelling is the step-by-step improvement observed: patients who received HA both before and after laser treatment experienced the greatest relief. Importantly, this combination treatment wasn’t just effective—it was also remarkably well-tolerated, with only minor, brief side effects such as warmth or temporary discharge, proving its safety and practicality in real-world use.

This suggests that HA doesn’t just complement laser therapy—it actively boosts its effects, likely by increasing tissue hydration, which optimizes laser absorption. This synergistic relationship between HA and VEL could be a game-changer for GSM treatment.

The study also emphasizes the value of personalized care, recognizing that each patient might need a tailored approach for the best results while maintaining comfort. By demonstrating a safe, non-hormonal, and clinically effective strategy for managing GSM, this research offers exciting possibilities for improving patient care.