Fractional CO2 laser treatment significantly increases vaginal fluid zinc and copper level
IUGA Academy. Kozma B. Jun 30, 2018; 212886
Dr. Bence Kozma
Dr. Bence Kozma

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Fractional CO2 laser treatment significantly increases vaginal fluid zinc and copper level

Kozma, B1; Takacs, P2; Poka, R1

1: University of Debrecen Faculty of Medicine, Department of Obstetrics and Gynecology, Debrecen, Hungary; 2: Eastern Virginia Medical School, Norfolk, Virginia, USA

Introduction: Fractional CO2 laser treatment became a popular treatment option for postmenopausal vaginal atrophy. The laser therapy creates microinjuries of the vagina and subsequent remodeling leads to the reorganization of the extracellular matrix of the vagina. Zinc and copper are essential trace elements and both play a vital role in tissue remodeling. Both zinc and copper functions as a cofactor for many enzymes participating in the composition of the extracellular matrix.

Objectives: To evaluate the effect of the Mona Lisa Touch CO2 laser treatment on postmenopausal women vaginal fluid trace element content: zinc and copper. Both zinc and copper play a pivotal role as a cofactor for several enzymes responsible for tissue remodeling. Our hypothesis was that increased tissue remodeling secondary to vaginal laser treatment will result in altered vaginal fluid zinc and copper content.

Materials and Methods: Twenty-seven postmenopausal women with genitourinary symptoms of menopause were enrolled and underwent vaginal laser treatment. Mona Lisa Touch is a functional vaginal rejuvenation treatment based on a special fractional CO2 laser, specifically created for the vaginal mucosa. Patients received three vaginal laser treatments with the 360 degree probe 4-6 weeks apart. Vaginal fluid was collected in a standardized fashion. Extreme care was exercised to avoid any possible contamination. Only single use plastic speculums free of trace elements were used. Atomic absorption spectroscopy was used to determine the vaginal fluid zinc and copper content. Paired t-test was used to compare the before and after treatment results.

Results: All patients were in menopause. The average age was 58 ± 9 years. The mean zinc level was 0.08 ± 0.08 mg/L before the initiation of the first treatment. After the first treatment the vaginal zinc level did not change significantly (0.08 ± 0.05 mg/L) But after the second laser treatment vaginal fluid zinc level was significantly higher 0.11 ± 0.07 mg/L (P< 0.01) and the third treatment increased vagina zinc levels even further to 0.16 ± 0.08 mg/L (P<0.01). The mean copper level was 0.008 ± 0.009 mg/L before the initiation of the first treatment. After the first and second treatment the vaginal copper level did not change significantly (0.010 ± 0.011 mg/L and 0.009 ± 0.008) But after the third laser treatment vaginal fluid copper level was significantly higher 0.016 ± 0.014 mg/L (P=0.04). Zinc content of the vaginal fluid was ten folds higher than copper levels.

Conclusion: Microablative fractional CO2 vaginal laser treatment significantly increases vaginal fluid zinc content. Zinc and copper levels increased by two folds after the third laser treatment. Elevated zinc and copper levels in the vaginal fluid is most likely occurs secondary to the increased vaginal remodeling.


Work supported by industry: no. A consultant, employee (part time or full time) or shareholder is among the authors (Fempharma).

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