The effect of microablative fractional CO2 laser on vaginal flora of postmenopausal women

Climacteric. 2016 Oct;19(5):512-8. doi: 10.1080/13697137.2016.1212006. Epub 2016 Aug 24.


Objectives: To assess the effect of microablative fractional CO2 laser (MFCO2-Laser) therapy on the vaginal microenvironment of postmenopausal women.

Methods: Three laser therapies at monthly intervals were applied in postmenopausal women with moderate to severe symptoms of genitourinary syndrome of menopause, pH of vaginal fluid >4.5 and superficial epithelial cells on vaginal smear <5%. Vaginal fluid pH values, fresh wet mount microscopy, Gram stain and aerobic and anaerobic cultures were evaluated at baseline and 1 month after each subsequent therapy. Nugent score and Hay-Ison criteria were used to evaluate vaginal flora.

Results: Fifty-three women (mean age 57.2 ± 5.4 years) participated and completed this study. MFCO2-Laser therapy increased Lactobacillus (p < 0.001) and normal flora (p < 0.001) after the completion of the therapeutic protocol, which decreased vaginal pH from a mean of 5.5 ± 0.8 (initial value) to 4.7 ± 0.5 (p < 0.001). The prevalence of Lactobacillus changed from 30% initially to 79% after the last treatment. Clinical signs and symptoms of bacterial vaginosis, aerobic vaginitis or candidiasis did not appear in any participant.

Conclusion: MFCO2-Laser therapy is a promising treatment for improving the vaginal health of postmenopausal women by helping repopulate the vagina with normally existing Lactobacillus species and reconstituting the normal flora to premenopausal status.

Keywords: UTIs; Vaginal atrophy; dyspareunia; intravaginal therapy; menopause; urinary tract infections; urogenital infections; vaginitis.

MeSH terms

  • Candidiasis, Vulvovaginal / epidemiology
  • Female
  • Humans
  • Lactobacillus / radiation effects*
  • Lasers, Gas / therapeutic use*
  • Logistic Models
  • Middle Aged
  • Postmenopause*
  • Prospective Studies
  • Tertiary Care Centers
  • Vagina / microbiology
  • Vagina / radiation effects*
  • Vaginitis / epidemiology
  • Vaginosis, Bacterial / epidemiology
  • Vulvovaginitis / surgery*