Effects of Erbium-Yag Laser in Women With Genitourinary Syndrome of Menopause Undergoing Estrogen Therapy

Patients will use low-dose isolated topical estrogen therapy in the form of estriol 1mg/g vaginal cream (Generic), with disposable, individualized vaginal applicators pre-set at the recommended dosage of 5g/dose each. Initially, they will use it for 14 consecutive nights, and then use it 2 times a week, always during the night, on Mondays and Thursdays, for 16 consecutive weeks from the start of the research. The treatment will be provided in fractions for each 30-day period and will always be delivered after each laser session, along with a leaflet containing usage, storage, and application instructions for the vaginal cream. The patients will be monitored through a messaging app, reinforcing the instructions and the days of application correctly.

All participants in the group will undergo 3 applications of the Er:YAG laser with an interval of 4-5 weeks between them. The intimate laser session consists of 2 stages, using a PS03-fractional tip: the internal stage (vaginal canal) and the external stage (region of the vestibule and introitus).

All participants in the group will undergo 3 applications of the Er:YAG laser with the device turned off, with an interval of 4-5 weeks between them. The intimate laser session consists of 2 stages, using a PS03 fractional tip: the internal stage (vaginal canal) and the external stage (vestibule and introitus region).