Efficacy and Safety of Radiofrequency as a Treatment Modality for Genitourinary Syndrome of Menopause: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

INTRODUCTION AND HYPOTHESIS: Existing treatment approaches to genitourinary syndrome of menopause (GSM) have constrained patient adherence. Radiofrequency (RF) therapy may address this issue. In this study we seek to assess the efficacy and safety of RF therapy in comparison with other interventions for the management of GSM.

METHODS

We performed pertinent literature searches in the Cochrane Library, Medline, Scopus, and ClinicalTrials.gov databases utilizing specific keywords. Continuous variables were aggregated into the mean difference (MD), whereas dichotomous variables were aggregated into odds ratios (OR) with 95% confidence intervals (95% CI) utilizing random-effects models.

RESULTS

A total of eight randomized clinical trials (RCTs) were included. Our pooled analysis demonstrated a more significant enhancement in the total Female Sexual Function Index (FSFI) score among patients with GSM undergoing RF therapy in comparison with those receiving vaginal estrogen (MD -5.57; 95% CI 2.42, 8.72; p = 0.0005) and placebo/moisturizer (MD 4.57; 95% CI 1.02, 8.12; p = 0.01). Nonetheless, RF therapy exhibited no substantial disparity in the total FSFI score whenever compared with laser therapy (MD 0.45; 95% CI -3.28, 4.17; p = 0.81). In terms of the Vaginal Health Index, RF therapy showed no significant difference compared with vaginal estrogen (p = 0.50), laser therapy (p = 0.97), and even with placebo/moisturizer (p = 0.14). The reported adverse events (AEs) were solely mild, with no serious AEs noted.

CONCLUSIONS

Radiofrequency therapy was associated with significantly greater improvement in sexual function than vaginal estrogen and placebo/moisturizer, but comparable with laser therapy. Vaginal health outcomes were similar across all comparators. Adverse events were exclusively mild, supporting an acceptable safety profile.