Assessment of the Efficacy and Safety of a Dual-Wavelength Diode Laser System for the Treatment of Vulvovaginal Atrophy in Women Without a History of Breast Cancer and in Patients with a History of Breast Cancer

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Background/Objectives: Vaginal laser therapy is a promising treatment for menopausal vulvovaginal atrophy (VVA). This study evaluates the efficacy of a dual-wavelength diode laser (980 + 1470 nm) in treating VVA. Methods: Thirty postmenopausal patients with moderate-to-severe VVA were recruited, and twenty-nine completed the study. Patients underwent a screening visit (T0); three laser sessions at 4-week intervals (T1, T2, and T3); and a follow-up visit 4 weeks after the last treatment (T4). At T0 and T4, the Schiller test and Vaginal Maturation Index (VMI) were performed; sexual function was assessed through the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Revised (FSDS-R). At each visit, the Vaginal Health Index (VHI) and the Visual Analog Scale (VAS) for dyspareunia were administered. Potential side effects were investigated, and the VAS for the pain associated with the procedure was assessed. Data analysis included the overall group and two subgroups: women with (group A) and without (group B) a history of breast cancer (BC). Results: Significant improvements in the VHI and reduced dyspareunia were observed at T4 compared to T0 in all groups. The improvement was already seen after the first procedure, with further improvement after the other procedures, being persistent at the 1-month follow-up. The Schiller test showed significant improvements from T0 to T4 in all groups. The VMI showed a significant improvement from T0 to T4 in the overall group and group B. The FSFI questionnaires showed a significant improvement in all areas for the whole population, whereas the FDSF-R questionnaire showed an improvement only in the overall group. Procedural pain was low (mean VAS 1.6), and no side effects were reported. Conclusions: The dual-wavelength diode laser is an effective and safe option for the treatment of VVA in patients with and without a history of BC.