Carboxytherapy for Genitourinary Syndrome of Menopause: A Pilot Study

Abstract Carboxytherapy has emerged as a promising nonhormonal therapy for genitourinary syndrome of menopause (GSM) and associated female sexual dysfunction. GSM, characterized by vulvovaginal tissue changes because of estrogen depletion, often leads to vaginal dryness, reduced elasticity, and dyspareunia. This pilot study aimed to evaluate the preliminary efficacy and safety of carboxytherapy in postmenopausal women with GSM. In this prospective pilot trial, postmenopausal women with GSM underwent 5 sessions of controlled CO2 administration using a specialized carboxytherapy device. Outcomes were assessed using the Bachmann Vaginal Health Index (VHI), the Vulvar Health Index (VuHI), the Female Sexual Function Index-6 (FSFI-6), and pain measured with the visual analog scale (VAS). Evaluations were performed at baseline and 1 month after treatment. Nineteen women completed the study. Posttreatment assessments demonstrated significant improvements in VHI scores (from 12.55 ± 2.56 to 18.26 ± 3.72; P < .001) and decreases in VuHI scores (from 9.80 ± 2.40 to 3.37 ± 3.67; P < .001). FSFI-6 scores improved from 12.55 ± 4.70 to 17.95 ± 7.61 (P = .017). Pain during treatment was minimal, with a mean VAS score of 1.95 ± 0.94. Carboxytherapy appears to be a safe, well-tolerated, and potentially effective nonhormonal option for managing GSM, particularly in cases with significant vulvar involvement. However, given the small sample size, lack of a control group, and short follow-up, these findings should be considered preliminary. Larger randomized controlled trials with longer follow-up are needed to confirm the durability and generalizability of these results. Level of Evidence: 4 (Therapeutic)