Fractional CO2 laser treatment for vaginal rejuvenation: a narrative review and comprehensive update

ABSTRACT
Vulvovaginal atrophy (VVA) and genitourinary syndrome of menopause (GSM) are common conditions affecting postmenopausal women, leading to symptoms such as dryness, itching, and dyspareunia. Traditional treatments include hormonal therapies and lubricants, but non-hormonal options have newly emerged. Vaginal rejuvenation has gained popularity in recent years, addressing a range of conditions related to aging, childbirth, and hormonal changes. Fractional carbon dioxide (CO2) laser treatment offers a minimally invasive approach to improve vaginal health, promoting collagen synthesis and enhancing tissue elasticity. Fractional CO2 lasers work by delivering controlled thermal energy to the vaginal tissue, creating micro-injuries that stimulate the body’s natural healing processes. These changes correlate with clinical improvements in vaginal hydration and pH levels. We emphasize the significant role of fractional CO2 laser treatment in vaginal rejuvenation in postmenopausal women with GSM. It offers a safe, minimally invasive, and effective option to improve their quality of life and sexual health. This review explores the mechanisms, clinical applications, safety, and patient satisfaction associated with fractional CO2 laser therapy, aiming to comprehensively understand its role in contemporary gynecological practice.