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October 12, 2021

Time for a “Pause” on the Use of Vaginal Laser

Author Affiliations
  • 1Department of Obstetrics and Gynecology, The University of Utah School of Medicine, Salt Lake City
JAMA. 2021;326(14):1378-1380. doi:10.1001/jama.2021.14809

In 2014, the North American Menopause Society and International Society for the Study of Women’s Sexual Health endorsed new terminology, genitourinary syndrome of menopause (GSM), to replace the term vulvovaginal atrophy.1 The new diagnostic term describes a collection of genital, sexual, and urinary symptoms, which affect up to an estimated 50% of postmenopausal women2 and are attributed to the menopausal decline in estrogen and other sex steroids. The renamed GSM diagnosis became associated with a repurposed treatment: vaginal laser therapy. These energy-based laser devices were initially cleared by the US Food and Drug Administration (FDA) for incision, excision, ablation, vaporization, and coagulation of body soft tissues in medical specialties, including plastic surgery, dermatology, podiatry, otolaryngology, neurosurgery, general surgery, and gynecology.3 However, the specific indication for the management of vulvovaginal atrophy was not included.4 By 2018, numerous companies in the US and worldwide were marketing devices to deliver laser energy to the vagina.