Comparing the effectiveness of vaginal laser therapy and hyaluronic acid suppositories in women with urogenital atrophy after breast cancer treatment

The study evaluated the effectiveness of vaginal laser therapy (VL) and hyaluronic acid suppositories (HAS) in women with urogenital atrophy after having breast cancer (BC) treatment. The data found that both VA therapy and HAS were equally effective in treating urogenital atrophy in these patients.

Many women experience various side effects after BC treatments such as chemotherapy and hormonal therapy. Urogenital atrophy is a common symptom and happens in more than 50% of women after BC therapy. Urogenital atrophy usually occurs in postmenopausal women due to a decrease in estrogen. Symptoms include vaginal dryness, urinary symptoms, and sexual dysfunction such as reduced libido and pain during intercourse.

The use of estrogen in this group of women has not been encouraged. A stronger treatment is needed that will improve a woman’s quality of life as well. Non-hormonal treatments such as VL therapy and HAS have been proven to be effective in relieving the symptoms. However, both therapies have not been compared for their effectiveness.

The study involved 43 women with a history of BC treatment and urogenital atrophy. The participants were randomly assigned and received either intravaginal laser therapy (22 participants; group 1) or HAS (21 participants; group 2). Group 1 received 2 courses of VL in 1 month and group 2 received treatment 3 times per week for 3 months.

After 3 months, the Vaginal Health Index (VHI) showed improvement in both treatment groups. There was no significant difference between the groups. Additionally, both treatments were effective in improving urogenital atrophy, sexual health, and quality of life, with no significant difference between the two groups.

After 3 months, vaginal atrophy was experienced by 91% in group 1 and reduced to 73% for group 1. In group 2, 86% of patients had vaginal atrophy before treatment which reduced to 67% after 3 months. Pain during intercourse significantly improved by 20% in group 1. There was a slight decrease in pain during intercourse in group 2.

Both treatments improved urinary symptoms. Incontinence symptoms were significantly improved in group 1.

52% of women in group 2 asked for VL therapy after 3 months due to ongoing vaginal atrophy.

The study concluded that both intravaginal laser therapy and hyaluronic acid suppositories were effective in treating urogenital atrophy in women who had BC treatment. 

The study had a short follow-up. More studies with a long follow-up are needed. This study was funded by Angelini and Asclepion, the manufacturers of the suppositories and laser therapy.