Photobiomodulation in post menopause genitourinary syndrome-Study protocol for a randomized, double-blind, controlled clinical protocol

PLoS One. 2024 Dec 2;19(12):e0313324. doi: 10.1371/journal.pone.0313324. eCollection 2024.

Abstract

Introduction: Genitourinary Syndrome of Menopause (GSM) defines a set of symptoms associated with an estrogen deficit involving alterations in organs genitourinary and that results in several urinary, genital, and sexual alterations. Brazilian women live about a third of their life after menopause, where hormonal changes occur along with clinical manifestations, characterized by vaginal and vulvar dryness, burning sensation, discomfort, vulvovaginal irritation, lack of lubrication, dyspareunia and urinary incontinence. Fractionated photothermolysis and radiofrequency systems, alone or in combination were tested to improve GSM.

Objective: The goal of this study is to elaborate a protocol to evaluate the clinical response of patients with symptoms of GSM after the application of photobiomodulation in the vulvar region.

Method: In this randomized, double-blind, placebo-controlled study protocol, women over 50 years of age who are in the postmenopausal period (amenorrhea for at least 12 months, with no pathology involved) with one or more symptoms of GSM will be randomly divided into two groups. The treatment group (n = 30) will receive four consecutive applications, weekly, using DMC laser diode (λ = 808 nm), 4J per point, 100mW of power, 1,016W/cm2, 8 sites in the vulvar region, The Placebo Group (n = 30) will be handled as treated, but with the laser turned off. The quality of life will be assessed using female sexual functioning index (FSFI-6), urinary incontinence questionnaire (ICIQ-SF), Quality of life will be analyzed using the female sexual functioning index (FSFI-6). The intensity of menopausal symptoms will be evaluated using a visual analogue scale (VAS), the vulvo vaginal atrophy will be measured by the Vaginal Health Index (VHI). Also, the vaginal temperature will be measured using a thermal camera, the pressure of the pelvic floor force (vaginal dynamometer) and a 1-hour Pad Test will be performed to quantify the urinary loss. With this procedure, we intend to obtain an overall better life quality and diminished symptoms in women with GSM. All assessments will be performed prior to the first irradiation and after the last one.

Trial registration: This protocol is registered at ClinicalTrials.gov under the number NCT05557799.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Brazil
  • Double-Blind Method
  • Female
  • Female Urogenital Diseases / therapy
  • Humans
  • Low-Level Light Therapy* / methods
  • Middle Aged
  • Postmenopause* / physiology
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Syndrome
  • Vagina / pathology
  • Vagina / physiopathology
  • Vagina / radiation effects
  • Vulva / pathology
  • Vulva / radiation effects

Associated data

  • ClinicalTrials.gov/NCT05557799

Grants and funding

The authors would like to acknowledge Institute of Research and Education in the Health Area (NUPEN) for offering the laser used in this work.