Red LED photobiomodulation in genitourinary health during the climacteric: results of a pilot study

Abstract

Hormonal changes during the climacteric are associated with genitourinary symptoms that compromise women's quality of life, including reduced vaginal lubrication, discomfort during intercourse, decreased genital sensitivity and altered sexual response. Photobiomodulation has attracted growing interest in regenerative gynecology for its capacity to stimulate cellular metabolism, microcirculation, angiogenesis and tissue repair through non-hormonal, minimally invasive mechanisms. The aim of this study was to evaluate the clinical and hemodynamic outcomes of red LED photobiomodulation in women with persistent genitourinary complaints. This was a prospective study of women in the climacteric or postmenopause who underwent a standardized protocol of 16 red LED sessions, performed twice weekly over eight weeks, with intravaginal application and complementary application to the external vulvar region. Clinical parameters, Female Sexual Function Index (FSFI-19) scores and hemodynamic indices of the dorsal clitoral artery assessed by Doppler ultrasound were recorded before and after treatment. All participants completed the protocol, with no relevant adverse events. Progressive improvement was observed in vaginal lubrication, intimate comfort, genital sensitivity and sexual satisfaction, with a marked increase in FSFI-19 scores. Doppler assessment demonstrated increased flow velocities (PSV from 28.8 to 35.4 cm/s; EDV from 4.62 to 10.18 cm/s; TAPV from 9.96 to 14.91 cm/s) and reduced vascular resistance indices (RI from 0.88 to 0.71; PI from 4.02 to 2.62), suggesting improved genital perfusion. The results indicate that red LED photobiomodulation represents a promising, non-hormonal therapeutic alternative for genitourinary changes associated with the climacteric; controlled studies with larger samples are needed to strengthen the level of evidence.