Carboxytherapy for Genitourinary Syndrome of Menopause: A Pilot Study

Background Carboxytherapy has emerged as a promising nonhormonal therapy for genitourinary syndrome of menopause (GSM) and associated female sexual dysfunction. GSM, characterized by vulvovaginal tissue changes due to estrogen depletion, often leads to vaginal dryness, reduced elasticity, and dyspareunia. Objectives This pilot study aimed to evaluate the preliminary efficacy and safety of carboxytherapy in postmenopausal women with GSM. Methods In this prospective pilot trial, postmenopausal women with GSM underwent five sessions of controlled CO₂ administration using a specialized carboxytherapy device. Outcomes were assessed using the Bachmann Vaginal Health Index (VHI), the Vulvar Health Index (VuHI), the Female Sexual Function Index-6 (FSFI-6), and pain measured with the Visual Analog Scale (VAS). Evaluations were performed at baseline and one month after treatment. Results Nineteen women completed the study. Post-treatment assessments demonstrated significant improvements in VHI scores (from 12.55 ± 2.56 to 18.26 ± 3.72; p < 0.001) and decreases in VuHI scores (from 9.80 ± 2.40 to 3.37 ± 3.67; p < 0.001). FSFI-6 scores improved from 12.55 ± 4.70 to 17.95 ± 7.61 (p = 0.017). Pain during treatment was minimal, with a mean VAS score of 1.95 ± 0.94. Conclusions Carboxytherapy appears to be a safe, well-tolerated, and potentially effective non-hormonal option for managing GSM, particularly in cases with significant vulvar involvement. However, given the small sample size, lack of a control group, and short follow-up, these findings should be considered preliminary. Larger randomized controlled trials with longer follow-up are needed to confirm the durability and generalizability of these results.