CLINICAL AND VAGINAL MICROBIOTA EFFECTS OF ORAL LACTOBACILLUS CRISPATUS M247 COMBINED WITH VAGINAL LASER THERAPY IN MENOPAUSAL WOMEN WITH ATROPHIC VULVOVAGINITIS: A PROSPECTIVE, RANDOMIZED AND CONTROLLED STUDY
Laser in Medical Science 2026
The study evaluates the effect of vaginal CO₂ laser treatment, combined or not, with an oral probiotic containing Lactobacillus crispatus M247 in postmenopausal women with vulvovaginal atrophy/GSM.
The combination of microfractionated CO₂ laser treatment and the oral probiotic L. crispatus M247 appears to offer additional benefits compared to laser treatment alone, especially for vaginal symptoms and microbiota profile, although the results should be interpreted with caution due to methodological limitations.
This was a prospective, randomized, controlled, open-label, multicenter study in which 75 postmenopausal women with VVA/GSM, randomized 2:1, underwent three sessions of microfractionated CO₂ laser (MonaLisa Touch) four weeks apart, with a 90-day follow-up.
• CO₂ laser alone (50 patients)
• CO₂ laser + oral probiotic (L. crispatus M247 for 90 days) (25 patients)
Both treatments in the two groups resulted in a significant reduction in GSM symptoms, although the laser + probiotic group
showed better results.
The most interesting result is the change in the microbiota.
This suggests that the probiotic enhances the reconstitution of the vaginal ecosystem, not just symptomatic control.
The microfractionated CO₂ laser improves GSM/VVA symptoms; the addition of L. crispatus M247 appears to amplify the clinical benefit and promote the restoration of a more physiological vaginal microbiota, suggesting a possible integrated “tissue + microbiota oriented” approach.
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