Abstract
BACKGROUND: Genitourinary syndrome of menopause (GSM) includes clinical manifestations attributed to estrogen deficiency affecting the genitourinary tract of postmenopausal women. Treatment may require a multifaceted approach, including patient education, lifestyle modifications, physical, as well as hormonal and non-hormonal therapies. AIMS: To evaluate the efficacy and tolerability of vaginal CO(2) laser therapy (MonaLisa Touch) combined with an oral food supplement containing bioactive collagen peptides (BCP) and other functional components for GSM treatment. We hypothesized that this combination would enhance GSM symptom relief. PATIENTS/METHODS: Twenty postmenopausal women with GSM were divided into two groups. Group 1 (n = 10) underwent three sessions of vaginal CO(2) laser treatment alone, while Group 2 (n = 10) received the same laser treatment in addition to oral food supplementation. Improvements in vaginal health (Vaginal Health Index-VHI), vaginal pain (Visual Analogue Scale-VAS), and sexual function (Female Sexual Function Index-FSFI), along with patient satisfaction and tolerability, were evaluated. RESULTS: Both groups showed improvements in VHI, pain scores, and FSFI, with Group 2 displaying more significant gains. Compared to Group 1, Group 2 had greater median differences in VHI (Δ = 11.00 vs. Δ = 8.50, p = 0.005) and VAS (Δ = -7.00 vs. Δ = -5.50, p = 0.017). Similarly, FSFI scores increased meaningfully in both groups, more so in Group 2 (from 53.50 to 67.50, p = 0.005 vs. from 51.50 to 60.50, p = 0.014 in Group 1). Treatment satisfaction was also higher in Group 2 (p = 0.047). CONCLUSIONS: The addition of oral supplementation with BCP and other functional components to vaginal CO(2) laser treatment for GSM offered significant benefits over laser treatment alone, improving vaginal health, reducing pain, and ameliorating sexual function. This combination therapy presents a promising non-hormonal option for GSM management, warranting further investigation in larger, long-term studies to confirm these preliminary findings.