{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T17:52:46Z","timestamp":1782150766542,"version":"3.54.5"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["113-N0021"],"award-info":[{"award-number":["113-N0021"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Genitourinary syndrome of menopause (GSM) is common, and non-hormonal treatment options are needed for women unsuitable for or reluctant to use estrogen therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To prospectively evaluate clinical outcomes and clinical improvement rates of photobiomodulation (PBM) for GSM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-seven postmenopausal women with GSM were enrolled in a prospective study conducted from January 2024 to July 2025. Participants received eight weekly 30-minute sessions of pulsed 660-nm PBM delivered through a stationary silicone vaginal light-guide probe. With the probe attached, target irradiance was 32.38mW\/cm\u00b2 at the probe tip and 13.38mW\/cm\u00b2 at the probe side, corresponding to per-session radiant exposures of 29.14J\/cm\u00b2 at the vaginal fornix and 12.04J\/cm\u00b2 at the vaginal wall. Assessments occurred at baseline (V1), pre-4th session (V2), pre-8th session (V3), and three months post-treatment (V4). The primary outcome was the Vaginal Health Index (VHI). Secondary outcomes included validated questionnaires for lower urinary tract symptoms (LUTS) and sexual function (FSFI). Clinical improvement was defined using established minimal clinically important differences (MCID), minimal detectable change (MDC), and cutoff scores as thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean age of participants was 62.9\u2009\u00b1\u20099.7 years. Total VHI scores were significantly higher at all follow-up time points compared to baseline (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), with all participants reaching the non-atrophic VHI threshold at V4. UDI-6, IIQ-7, OABSS, and several KHQ domains improved significantly (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and persisted through the 3-month follow-up. Total FSFI scores improved significantly (p\u2009&lt;\u20090.05), but only 13.3% reached the clinical cutoff (\u226526.5) at V4 for functional recovery. No adverse events were observed during the study period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intravaginal 660-nm PBM is a well-tolerated, non-hormonal modality that may improve objective vaginal health and subjective symptoms in GSM. As an integrated therapeutic option, PBM may also improve GSM-related LUTS, suggesting potential relevance for geriatric patients with polypharmacy concerns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec006\">\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT06074120\" xlink:type=\"simple\">NCT06074120<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0351765","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T17:38:23Z","timestamp":1782149903000},"page":"e0351765","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of photobiomodulation therapy for genitourinary syndrome of menopause: A single-center prospective study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9799-7414","authenticated-orcid":true,"given":"Pei-Chi","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho-Hsiung","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4903-7878","authenticated-orcid":true,"given":"Chi-Hau","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yih-Shing","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"issue":"4","key":"pone.0351765.ref001","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1080\/13697137.2025.2514029","article-title":"Enhancing quality of life: addressing vulvovaginal atrophy and urinary tract symptoms","volume":"28","author":"AL Hirschberg","year":"2025","journal-title":"Climacteric"},{"issue":"5","key":"pone.0351765.ref002","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1097\/GME.0000000000001728","article-title":"The genitourinary syndrome of menopause","volume":"28","author":"NA Phillips","year":"2021","journal-title":"Menopause"},{"issue":"5","key":"pone.0351765.ref003","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1001\/jama.2022.24140","article-title":"Management of Menopausal Symptoms: A Review","volume":"329","author":"CJ Crandall","year":"2023","journal-title":"JAMA"},{"issue":"10430","key":"pone.0351765.ref004","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/S0140-6736(23)02802-7","article-title":"Managing menopause after cancer","volume":"403","author":"M Hickey","year":"2024","journal-title":"Lancet"},{"key":"pone.0351765.ref005","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.maturitas.2021.06.005","article-title":"Vaginal laser therapy for genitourinary syndrome of menopause - systematic review","volume":"156","author":"E Mension","year":"2022","journal-title":"Maturitas"},{"issue":"11","key":"pone.0351765.ref006","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1097\/GME.0000000000001845","article-title":"Vaginal CO2 laser therapy versus sham for genitourinary syndrome of menopause management: a systematic review and meta-analysis of randomized controlled trials","volume":"28","author":"Y Khamis","year":"2021","journal-title":"Menopause"},{"issue":"5","key":"pone.0351765.ref007","doi-asserted-by":"crossref","first-page":"835","DOI":"10.17219\/acem\/37263","article-title":"The use of low-level energy laser radiation in basic and clinical research","volume":"23","author":"P Rola","year":"2014","journal-title":"Adv Clin Exp Med"},{"key":"pone.0351765.ref008","doi-asserted-by":"crossref","first-page":"122623","DOI":"10.1016\/j.biomaterials.2024.122623","article-title":"Tailoring photobiomodulation to enhance tissue regeneration","volume":"309","author":"I Selestin Raja","year":"2024","journal-title":"Biomaterials"},{"issue":"5","key":"pone.0351765.ref009","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1016\/j.jaad.2023.10.073","article-title":"Photobiomodulation CME part I: Overview and mechanism of action","volume":"91","author":"J Maghfour","year":"2024","journal-title":"J Am Acad Dermatol"},{"issue":"1","key":"pone.0351765.ref010","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1007\/s10103-025-04393-z","article-title":"Review on the molecular mechanisms of low-level laser therapy: gene expression and signaling pathways","volume":"40","author":"R Tamimi","year":"2025","journal-title":"Lasers Med Sci"},{"key":"pone.0351765.ref011","first-page":"1574646","article-title":"The efficacy of low-level laser therapy in alleviating genitourinary syndrome of menopause and stress urinary incontinence: the pilot study","volume":"12","author":"P-C Wu","year":"2025","journal-title":"Front Med (Lausanne)"},{"issue":"12","key":"pone.0351765.ref012","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1089\/pho.2011.9895","article-title":"How to report low-level laser therapy (LLLT)\/photomedicine dose and beam parameters in clinical and laboratory studies","volume":"29","author":"PA Jenkins","year":"2011","journal-title":"Photomed Laser Surg"},{"issue":"4","key":"pone.0351765.ref013","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1080\/13697137.2019.1600499","article-title":"Assessing symptomatic vulvar, vaginal, and lower urinary tract atrophy","volume":"22","author":"S Palacios","year":"2019","journal-title":"Climacteric"},{"issue":"6","key":"pone.0351765.ref014","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1002\/nau.20546","article-title":"The Chinese version of ICIQ: a useful tool in clinical practice and research on urinary incontinence","volume":"27","author":"L Huang","year":"2008","journal-title":"Neurourol Urodyn"},{"issue":"2","key":"pone.0351765.ref015","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1002\/nau.1930140206","article-title":"Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group","volume":"14","author":"JS Uebersax","year":"1995","journal-title":"Neurourol Urodyn"},{"issue":"2","key":"pone.0351765.ref016","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.urology.2006.02.042","article-title":"Symptom assessment tool for overactive bladder syndrome--overactive bladder symptom score","volume":"68","author":"Y Homma","year":"2006","journal-title":"Urology"},{"issue":"12","key":"pone.0351765.ref017","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1111\/j.1471-0528.1997.tb11006.x","article-title":"A new questionnaire to assess the quality of life of urinary incontinent women","volume":"104","author":"CJ Kelleher","year":"1997","journal-title":"Br J Obstet Gynaecol"},{"key":"pone.0351765.ref018","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.ejon.2015.06.007","article-title":"Sexual function in cervical cancer patients: Psychometric properties and performance of a Chinese version of the Female Sexual Function Index","volume":"20","author":"H Liu","year":"2016","journal-title":"Eur J Oncol Nurs"},{"issue":"14","key":"pone.0351765.ref019","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1001\/jama.2021.14892","article-title":"Effect of Fractional Carbon Dioxide Laser vs Sham Treatment on Symptom Severity in Women With Postmenopausal Vaginal Symptoms: A Randomized Clinical Trial","volume":"326","author":"FG Li","year":"2021","journal-title":"JAMA"},{"issue":"12","key":"pone.0351765.ref020","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1097\/GME.0000000000002617","article-title":"Understanding the sexual concerns of older women presenting for care to women\u2019s health clinics: a cross-sectional study","volume":"32","author":"J Karam","year":"2025","journal-title":"Menopause"},{"issue":"12","key":"pone.0351765.ref021","doi-asserted-by":"crossref","first-page":"3033","DOI":"10.1007\/s00192-023-05657-4","article-title":"Novel clinically meaningful scores for the ICIQ-UI-SF and ICIQ-FLUTS questionnaires in women with stress incontinence","volume":"34","author":"SI Nipa","year":"2023","journal-title":"Int Urogynecol J"},{"issue":"4","key":"pone.0351765.ref022","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1016\/j.urology.2011.06.020","article-title":"Responsiveness and minimal clinically important change in overactive bladder symptom score","volume":"78","author":"M Gotoh","year":"2011","journal-title":"Urology"},{"issue":"6","key":"pone.0351765.ref023","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1111\/j.1471-0528.2004.00129.x","article-title":"How much is enough and who says so?","volume":"111","author":"CJ Kelleher","year":"2004","journal-title":"BJOG"},{"key":"pone.0351765.ref024","doi-asserted-by":"crossref","first-page":"2930","DOI":"10.1080\/09638288.2020.1720319","article-title":"Italian versions of the Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7: translation and validation in women with urinary incontinence","volume":"43","author":"M Monticone","year":"2021","journal-title":"Disabil Rehabil"},{"key":"pone.0351765.ref025","doi-asserted-by":"crossref","first-page":"108737","DOI":"10.1016\/j.maturitas.2025.108737","article-title":"Microablative and non-ablative laser and radiofrequency treatment of genitourinary syndrome of menopause: A randomised controlled trial with four different energies","volume":"202","author":"H Slongo","year":"2025","journal-title":"Maturitas"},{"issue":"4","key":"pone.0351765.ref026","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1080\/13697137.2023.2225766","article-title":"Vaginal laser therapy for GSM\/VVA: where we stand now - a review by the EUGA Working Group on Laser","volume":"26","author":"S Salvatore","year":"2023","journal-title":"Climacteric"},{"issue":"12","key":"pone.0351765.ref027","doi-asserted-by":"crossref","first-page":"4617","DOI":"10.1007\/s12325-024-03004-7","article-title":"Efficacy and Safety of Non-Ablative Dual Wavelength Diode Laser Therapy for Genitourinary Syndrome of Menopause: A Single-Center Prospective Study","volume":"41","author":"SG Vitale","year":"2024","journal-title":"Adv Ther"},{"issue":"10","key":"pone.0351765.ref028","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1097\/GME.0000000000001577","article-title":"Vaginal laser treatment of genitourinary syndrome of menopause: does the evidence support the FDA safety communication?","volume":"27","author":"JZ Guo","year":"2020","journal-title":"Menopause"},{"issue":"6","key":"pone.0351765.ref029","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1016\/j.ajog.2016.07.045","article-title":"Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management","volume":"215","author":"J Gandhi","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"pone.0351765.ref030","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1111\/php.12864","article-title":"Mechanisms and Mitochondrial Redox Signaling in Photobiomodulation","volume":"94","author":"MR Hamblin","year":"2018","journal-title":"Photochem Photobiol"},{"issue":"3","key":"pone.0351765.ref031","doi-asserted-by":"crossref","first-page":"7000417","DOI":"10.1109\/JSTQE.2016.2561201","article-title":"Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy","volume":"22","author":"LF de Freitas","year":"2016","journal-title":"IEEE J Sel Top Quantum Electron"},{"key":"pone.0351765.ref032","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.jphotobiol.2013.11.018","article-title":"Expression of genes in normal fibroblast cells (WS1) in response to irradiation at 660nm","volume":"130","author":"NN Houreld","year":"2014","journal-title":"J Photochem Photobiol B"},{"issue":"1","key":"pone.0351765.ref033","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1186\/s12967-025-07466-3","article-title":"From light to healing: photobiomodulation therapy in medical disciplines","volume":"23","author":"P Shivappa","year":"2025","journal-title":"J Transl Med"},{"key":"pone.0351765.ref034","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.jphotobiol.2018.10.011","article-title":"Role of photobiomodulation on the activation of the Smad pathway via TGF-\u03b2 in wound healing","volume":"189","author":"D Mokoena","year":"2018","journal-title":"J Photochem Photobiol B"},{"issue":"3","key":"pone.0351765.ref035","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/wrr.13010","article-title":"Interplay between epithelial and mesenchymal cells unveils essential proinflammatory and pro-resolutive mediators modulated by photobiomodulation therapy at 660\u2009nm","volume":"30","author":"RF Oliveira","year":"2022","journal-title":"Wound Repair Regen"},{"issue":"6","key":"pone.0351765.ref036","doi-asserted-by":"crossref","first-page":"1724","DOI":"10.3390\/jcm9061724","article-title":"Photobiomodulation - Underlying Mechanism and Clinical Applications","volume":"9","author":"C Dompe","year":"2020","journal-title":"J Clin Med"},{"issue":"5","key":"pone.0351765.ref037","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1093\/asj\/sjab396","article-title":"Correction to: Photobiomodulation: The Clinical Applications of Low-Level Light Therapy","volume":"42","author":"GE Glass","year":"2022","journal-title":"Aesthet Surg J"},{"issue":"7","key":"pone.0351765.ref038","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1097\/GME.0000000000001081","article-title":"Vaginal pH: a simple assessment highly correlated with vaginal morphology and symptoms in postmenopausal women","volume":"25","author":"KM Tucker","year":"2018","journal-title":"Menopause"},{"issue":"2","key":"pone.0351765.ref039","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/GME.0000000000000967","article-title":"Prevalence of sexual symptoms in relation to menopause in women in Asia: a systematic review","volume":"25","author":"RM Islam","year":"2018","journal-title":"Menopause"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0351765","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T17:38:29Z","timestamp":1782149909000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0351765"}},"subtitle":[],"editor":[{"given":"Michael R","family":"Hamblin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":39,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0351765","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]}}}