Okui Nobuo
Dentistry, Kanagawa Dental University, Yokosuka, JPN.
Cureus. 2023 Sep 18;15(9):e45495. doi: 10.7759/cureus.45495. eCollection 2023 Sep.
Vulvovaginal atrophy (VVA) is a chronic condition resulting from reduced estrogen levels during menopause. The North American Menopause Society and the International Society for the Study of Women's Sexual Health suggested the term "genitourinary syndrome of menopause" (GSM) to indicate the broader aspects of VVA. Breast cancer treatments, such as chemotherapy and endocrine therapy, can induce early and abrupt menopausal symptoms, including GSM, which negatively affects sexual function and the quality of life of the survivors. Vaginal laser therapy has emerged as a safe and effective option for the management of GSM in breast cancer survivors (BCSs). Two main types of lasers, the non-ablative erbium:YAG laser and fractional microablative CO vaginal laser, have been evaluated for GSM treatment. While there are few randomized controlled trials (RCTs) on the subject of BCSs, a wealth of prospective and retrospective studies have highlighted the beneficial effects of vaginal laser therapy on the symptoms of VVA, vaginal health, sexual function, and overall quality of life. More comprehensive research is essential to confirm its enduring effectiveness and safety, with a focus on conducting standardized and meticulously controlled investigations. This study is a narrative review that summarizes clinical trials ranging from the earliest to the most recent ones on laser treatment for GSM in BCSs.
外阴阴道萎缩（VVA）是一种由于绝经期间雌激素水平降低导致的慢性疾病。北美更年期协会和国际女性性健康研究协会建议使用“绝经后泌尿生殖综合征”（GSM）这一术语来表明VVA更广泛的方面。乳腺癌治疗，如化疗和内分泌治疗，可诱发包括GSM在内的早期和突然的绝经症状，这会对幸存者的性功能和生活质量产生负面影响。阴道激光治疗已成为乳腺癌幸存者（BCS）管理GSM的一种安全有效的选择。两种主要类型的激光，即非剥脱性铒：钇铝石榴石激光和分次微剥脱性CO2阴道激光，已被评估用于GSM治疗。虽然关于BCS的随机对照试验（RCT）很少，但大量的前瞻性和回顾性研究强调了阴道激光治疗对VVA症状、阴道健康、性功能和整体生活质量的有益影响。更全面的研究对于确认其持久有效性和安全性至关重要，重点是进行标准化和严格控制的调查。本研究是一篇叙述性综述，总结了从最早到最近关于BCS中GSM激光治疗的临床试验。
