Objective: To compare the efficacy and safety of fractional microablative radiofrequency (RF) and topical estriol in the treatment of genitourinary syndrome of menopause (GSM).
Methods: This pilot randomized controlled trial included 30 healthy postmenopausal women with GSM. Participants were randomly assigned to receive either fractional microablative RF plus placebo cream (RF group) or topical estriol plus sham RF (estriol group). Both treatments were administered over 3 months. Primary outcomes included vaginal health (Vaginal Health Index Score-VHIS), sexual function (Female Sexual Function Index-FSFI), and urinary symptoms (International Consultation on Incontinence Questionnaire-Short Form-ICIQ-SF). Safety was assessed through reports of adverse effects.
Results: Both RF and estriol significantly improved VHIS, FSFI, and ICIQ-SF scores (p < 0.05). Estriol provided greater improvement in sexual desire, while RF demonstrated superior results in satisfaction, dyspareunia reduction, and epithelial elasticity. No severe adverse effects occurred; mild discomfort was reported in the RF group.
Conclusion: Fractional microablative RF and topical estriol are both effective and safe for relieving GSM symptoms. RF offers a promising non-hormonal alternative, especially for women who cannot or choose not to use estrogen therapy.
Keywords: estriol; menopause; radiofrequency; treatment.
© 2025 The Author(s). International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.