{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:23:59Z","timestamp":1790742239769,"version":"4.1.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Photobiomodulation, Photomedicine, and Laser Surgery"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>\n                      This study aimed to evaluate the vagina clinically, cytologically, and histologically before and after treating genitourinary syndrome of menopause (GSM) with fractional microablative carbon dioxide LASER (CO\n                      <jats:sub>2<\/jats:sub>\n                      L), radiofrequency (RF), and estrogen vaginal cream (CT).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Women with moderate-to-severe symptoms of GSM, denoted by a GSM Visual analog scale (VAS) score of &gt;4, were eligible for this study. The patients were randomized into treatment groups. In the energy groups, three vulvovaginal applications were administered monthly. The CT group used 0.5 mg vaginal estriol cream for 14 consecutive days, followed by twice a week for 4 months. The follow-up visits occurred 120 days after the beginning of the treatments. The same parameters obtained at the first visit were re-evaluated: GSM VAS score, Incontinence Quality of Life Questionnaire (I-QOL), gynecological examination determining Vaginal Health Index (VHI), vaginal smear for Vaginal Maturation Value (VMV), and vaginal biopsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Seventy-one women were included, 48 completed the study and provided adequate samples for analysis (CO\n                      <jats:sub>2<\/jats:sub>\n                      L [21 patients], RF [15 patients], and CT [12 patients]). GSM symptoms, I-QOL, and VHI significantly improved after all proposed treatments, with no significant differences between them. VMV did not change after any treatment; however, only 22.9% of the patients presented with cytological atrophy before treatment. Histological vaginal atrophy was identified in 6 (12.5%) pretreated vaginal samples. After the intervention, all histological parameters were normalized, no tissue damage was observed, and no major clinical complications were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      CO\n                      <jats:sub>2<\/jats:sub>\n                      L and RF seem to be good alternatives to CT for GSM treatment, with no tissue damage.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/pho.2023.0110","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T07:24:47Z","timestamp":1718695487000},"page":"414-421","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Fractional and Microablative CO\n                    <sub>2<\/sub>\n                    LASER and Radiofrequency in the Treatment of Genitourinary Syndrome of Menopause: A Descriptive Study"],"prefix":"10.1177","volume":"42","author":[{"given":"Maria Cristina","family":"Caceres Nogueira","sequence":"first","affiliation":[{"name":"Department of Gynecology, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Maria","family":"Homem de Mello Bianchi-Ferraro","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalena","family":"Leonor Pereira Campos","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9377-1984","authenticated-orcid":false,"given":"Carla","family":"Dias Oliveira","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marair","family":"Gracio Ferreira Sartori","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsuzsanna Ilona Katalin de J\u00e1rmy","family":"Di Bella","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Flavia","family":"Logullo","sequence":"additional","affiliation":[{"name":"Department of Pathology, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"LARF study group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neila Maria Gois","family":"Speck","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Federal University of S\u00e3o Paulo (UNIFESP), S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,6,22]]},"reference":[{"key":"e_1_3_7_2_2","unstructured":"IBGE \u2013 Brazilian Institute of Geography and Statistics. Life expectancy was 76.6 years in 2019 [Internet]. Dispon\u00edvel em. Available from: https:\/\/agenciadenoticias.ibge.gov.br\/en\/agencia-press-room\/2185-news-agency\/releases-en\/29510-life-expectancy-was-76-6-years-in-2019 [Last accessed: 10 de]."},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-014-1677-2"},{"issue":"3","key":"e_1_3_7_4_2","article-title":"Effect of the use of no hormonal gel in genital region in postmenopausal women","volume":"71","author":"Silva I","year":"2014","unstructured":"Silva I. Effect of the use of no hormonal gel in genital region in postmenopausal women. RBM Rev Bras Med. mar\u00e7o de, 2014; 71(3).","journal-title":"RBM Rev Bras Med. mar\u00e7o de"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000001333"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.3109\/13697137.2015.1107039"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000001416"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000000955"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2021.12.010"},{"issue":"20","key":"e_1_3_7_10_2","first-page":"4190","article-title":"Postmenopausal vulvovaginal atrophy (VVA) is positively improved by topical hyaluronic acid application. A prospective, observational study","volume":"20","author":"Origoni M","year":"2016","unstructured":"Origoni M, , Cimmino C, , Carminati G, et al. Postmenopausal vulvovaginal atrophy (VVA) is positively improved by topical hyaluronic acid application. A prospective, observational study. 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Long term nonhormonal treatment of vaginal dryness. 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