Objective: To evaluate the short term efficacy and safety of Fractional CO2 laser for the treatment of vulvovaginal atrophy.
Material and Method: From March 2015 to October 2015, 112 menopausal women were recruited. All women with VVA
were treated by using Fractional CO2 laser; power 30 watts, 1-3 stacks with 360° vaginal probe for 3 consecutive times, 4 weeks apart. Before laser treatment, the subjective measurement of VVA symptoms was evaluated by using a questionnaire and the objective measurements were evaluated by using pH paper and VMI. Visual analog pain-score was used to scaling their discomfort during and immediately after each treatment. At 3 months after the last procedure, the subjective and objective measurements were re-assessed. Any short-term and long-term adverse events were recorded. Statistical analysis was performed by using SPSS program with p-value <0.05.
Results: The median of pre-screening VVA symptom score was 4 and the most bothersome symptom was the “feeling of dryness around vulvar”. There was a significant reduction of the score after laser treatment. The average percentage of pretreatment VMI was 34.7+16.1% and at one and three months after complete laser course, it was significantly increased with the mean change of 25.0+12.2% and 34.8+15.5%, respectively. For the vaginal pH, the average pH before treatment was 7.5+1.0 and the average decrement after 3 months was 0.9+1.3 with statistical significance, p-value <0.01. There were no serious complications and all were satisfied with the treatment.
Conclusion: Fractional CO2 laser could ameliorate the VVA symptoms with at least 3 months of long lasting improvement of vaginal health with safety.

Keywords: Vulvovaginal atrophy, Fractional CO2 laser, Efficacy, VMI