Palabras clave
Síndrome genitourinario
Atrofia vaginal
Cómo citar
Copyright © | Todos los derechos reservados.
La revista posee los derechos de autor exclusivos para la publicación de este artículo en los términos de la ley brasileña 9610/98.
Reproducción parcial
El uso de partes de los textos, figuras y cuestionario del artículo es libre, siendo obligatoria la citación de los autores y revista.
Reproducción total
Está expresamente prohibido y debe ser autorizado por la revista.
Resumen
Objetivo: Describir las evidencias científicas sobre el uso del láser vaginal en el síndrome genitourinario de la menopausia, evaluando su eficacia y su impacto en la calidad de vida. Métodos: Se realizó una revisión en bases de datos científicas (BVS, PubMed y SciELO) entre mayo y agosto de 2025, utilizando los descriptores “Vaginal Atrophy”, “Lasers, Medical”, “Postmenopause” y “Menopause”, incluidos en MeSH. Se incluyeron artículos en inglés, portugués o español, de acceso gratuito y publicados en los últimos cinco años. Resultados: El láser vaginal (CO₂ y Er:YAG) se presenta como una terapia prometedora para el síndrome genitourinario de la menopausia, con mejoría de síntomas como sequedad, dolor y dispareunia, así como de la función sexual, mediante la estimulación del colágeno y la vascularización. Los estudios señalan seguridad y eficacia a corto plazo; sin embargo, persisten limitaciones relacionadas con la falta de evidencia a largo plazo, los altos costos y la ausencia de protocolos estandarizados. Consideraciones finales: El láser vaginal constituye una alternativa innovadora y segura, especialmente para mujeres con contraindicación a la terapia hormonal. No obstante, se requieren estudios longitudinales, estandarización de protocolos y análisis de costo-efectividad para consolidar su uso clínico.
Referencias
ASHRAF AB, et al. Genitourinary syndrome of menopause: a multicenter study from the Indian Midlife Registry. Climacteric, 2025; 28(3): 329-336.
CREAN-TATE KK, et al. Management of genitourinary syndrome of menopause in female cancer patients: a focus on vaginal hormonal therapy. American journal of obstetrics and gynecology, 2020; 222(2): 103-113.
FAUBION SS, et al. Genitourinary syndrome of menopause: management strategies for the clinician. In: Mayo Clinic Proceedings. Elsevier, 2017; 1842-1849.
GABRIELI D, et al. “Modified Schirmer Test” as an Objective Measurement for Vaginal Dryness: A Prospective Cohort Study. Diagnostics, 2022; 12(3): 574.
GANDHI J, et al. Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. American journal of obstetrics and gynecology, 2016; 215(6): 704-711.
GASPAR A, et al. Vaginal fractional CO2 laser: a minimally invasive option for vaginal rejuvenation. The American Journal of Cosmetic Surgery, 2011; 28(3): 156-162.
GHANBARI Z, et al. Vaginal CO2 Fractional Laser in Women With Vaginal Atrophy: Medical Insights on Short-and Long-term Effects on Genitourinary Symptoms. Journal of Lasers in Medical Sciences, 2024; 15: e59.
GOLD D, et al. Vaginal laser therapy versus hyaluronic acid suppositories for women with symptoms of urogenital atrophy after treatment for breast cancer: a randomized controlled trial. Maturitas, 2023; 167: 1-7.
HYMPANOVA L, et al. The ewe as an animal model of vaginal atrophy and vaginal Er: YAG laser application. Menopause, 2021; 28(2): 198-206.
JABER S, et al. CO2 Laser Therapy for Genitourinary Syndrome of Menopause in Women with Breast Cancer: A Randomized, Sham-Controlled Trial. Cancers, 2025; 17(7): 1241.
KAPLAN I, et al. GER R. The treatment of erosions of the uterine cervix by means of the CO2 laser. Obstetrics & Gynecology, 1973; 41(5): 795-796.
KINGSBERG SA, et al. The women's EMPOWER survey: identifying women's perceptions on vulvar and vaginal atrophy and its treatment. The journal of sexual medicine, 2017; 14(3): 413-424.
MAC BRIDE MB, et al. Vulvovaginal atrophy. In: Mayo Clinic Proceedings. Elsevier, 2010; 87-94.
MACHADO AC, et al. Applicability of vaginal energy-based devices in urogynecology: evidence and controversy. Revista da Associação Médica Brasileira, 2023; 69(suppl 1): e2023S129.
MARINO JM. Genitourinary syndrome of menopause. Journal of midwifery & women's health, 2021; 66(6): 729-739.
MERLINO L, et al. Therapeutic choices for genitourinary syndrome of menopause (GSM) in breast cancer survivors: a systematic review and update. Pharmaceuticals, 2023; 16(4): 550.
NAPPI RE, KOKOT-KIEREPA M. Vaginal Health: Insights, Views & Attitudes (VIVA)–results from an international survey. Climacteric, 2012; 15(1): 36-44.
PARAISO MFR, et al. A randomized clinical trial comparing vaginal laser therapy to vaginal estrogen therapy in women with genitourinary syndrome of menopause: The VeLVET Trial. Menopause, 2020; 27(1): 50-56.
PARDO J, et al. Laser labioplasty of labia minora. International journal of gynecology & obstetrics, 2006; 93(1): 38-43.
PHILLIPS NA, BACHMANN GA. The genitourinary syndrome of menopause. Menopause, 2021; 28(5): 579-588.
PINHO SC, et al. Efficacy of fractional laser on steroid receptors in GSM patients. Bioengineering, 2023; 10(9): 1087.
PRODROMIDOU A, et al. CO2 laser versus sham control for the management of genitourinary syndrome of menopause: a systematic review and meta-analysis of randomized controlled trials. Journal of Personalized Medicine, 2023; 13(12): 1694.
QUICK AM, et al. Long-term follow-up of fractional CO2 laser therapy for genitourinary syndrome of menopause in breast cancer survivors. Journal of Clinical Medicine, 2022; 11(3): 774.
TADIR Y, et al. Energy-based treatment for gynecologic conditions including genitourinary syndrome of menopause: consensus, controversies, recommendations, and FDA clearance. Lasers in surgery and medicine, 2019; 51(4): 315-317.
U.S. Food and Drug Administration. Product classification. Disponível em: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpcd/classification.cfm?ID561299.
U.S. Food and Drug Administration (2018) Statement from FDA Commissioner Scott Gottlieb, M.D., on Efforts to Safeguard Women’s Health from Deceptive Health Claims and Significant Risks Related to Devices Marketed for Use in Medical Procedures for “Vaginal Rejuvenation”. Disponível em: https://www.fda.gov/news-events/press-announcements/statement-fda-commissioner-scott-gottlieb-md-efforts-safeguard-womens-health-deceptive-health-claims.
WOŹNIAK A, et al. Efficacy of Fractional CO2 Laser Treatment for Genitourinary Syndrome of Menopause in Short-Term Evaluation—Preliminary Study. Biomedicines, 2023; 11(5): 1304.
WOŹNIAK S, WOŹNIAK A. Assessing the Long-Term Effectiveness of Fractional CO2 Laser Treatment in Perimenopausal Women with Genitourinary Syndrome of Menopause—Single Center Preliminary Study. Journal of Clinical Medicine, 2025; 14(1): 242.