Clinical and sexual function outcomes following intravaginal 1470-nm diode laser therapy for genitourinary syndrome of menopause: a prospective pilot study

Introduction. Genitourinary syndrome of menopause (GSM) is a chronic condition associated with estrogen de­fi­ciency, resulting in vaginal dryness, burning, dyspareunia and impaired sexual function due to progressive mucosal atro­phy and connective tissue degeneration. Energy-based va­gi­nal laser therapies have demonstrated tissue-level re­ge­ne­ra­tive effects through controlled thermal stimulation and activation of wound-healing pathways. Objective. To eva­lu­ate the clinical efficacy, sexual function outcomes and safety of 1470-nm diode laser therapy in postmenopausal wo­men with GSM. Methodology. This prospective ob­ser­va­tio­nal pilot study enrolled 25 postmenopausal women with moderate to severe GSM. The participants underwent three sessions of intravaginal 1470-nm diode laser therapy at two-week intervals. The outcomes were assessed at base­line and three months post-treatment, using GSM symp­tom severity scores, Vaginal Health Index (VHI) and Fe­male Sexual Function Index (FSFI) in sexually active par­ti­ci­pants. Safety outcomes were recorded throughout the study period. Results. The mean age of participants was 56.8±6.2 years old, with a mean duration since menopause of 7.4±3.1 years. At the three-month follow-up, mean va­gi­nal dryness scores decreased from 7.8±1.1 to 3.2±1.2 (p<0.001), the burning scores decreased from 6.2±1.4 to 2.9±1.1 (p<0.001), and the dyspareunia scores dec­reased from 7.1±1.3 to 3.1±1.2 (p<0.001). Mean VHI scores im­proved significantly from 12.1±2.3 at baseline to 19.8±2.6 at three months (p<0.001). Among sexually ac­tive par­ti­ci­pants (n=15), the total FSFI scores increased from 18.6±4.1 to 26.7±4.6 (p<0.001). Conclusions. In this prospective pi­lot study, intravaginal 1470-nm diode la­ser therapy was as­so­cia­ted with significant short-term im­prove­ment in GSM symptoms, vaginal health and sexual function, with a fa­vora­ble safety profile. These findings are consistent with pre­viously reported regenerative mechanisms of 1470-nm laser va­gi­nal therapy. Larger randomized controlled trials with ex­ten­ded follow-up are warranted to confirm the durability and long-term clinical benefit.