Vaginal Atrophy (GSM) Solutions Doctor-Led, Evidence-Informed

The Mechanism: The laser delivers controlled thermal energy to the vaginal lining. This micro-injury intends to stimulate fibroblasts (collagen-producing cells) and increase blood vessel formation (neovascularisation), promoting tissue remodelling[cite: 207].

The Protocol: Most protocols involve 3 sessions spaced 4–6 weeks apart. A small probe delivers 360-degree treatment, typically taking 5-15 minutes with no anaesthesia required [cite: 205, 208-209].

Clinical Note: As per NICE IPG697, we use this only in a research-governed context due to the need for more long-term efficacy data[cite: 213].

Biological Theory: We concentrate your own blood's platelets, which contain growth factors like PDGF and VEGF. When injected, these are thought to attract stem cells and trigger natural tissue regeneration and blood flow improvements [cite: 220-221].

Evidence Status: PRP is an emerging biologic option. Pilot studies report improvements in the Vaginal Health Index and dyspareunia, but large-scale long-term trials are still developing[cite: 223].

How it works: Hyaluronic acid (HA) is a naturally occurring molecule that holds up to 1,000 times its weight in water. Unlike surface moisturisers, injectable HA is placed within tissue layers to provide deep cushioning, hydration, and support for elasticity [cite: 226-228].

Best For: Women seeking immediate non-hormonal hydration or those with contraindications to oestrogen[cite: 235].

The Concept: Exosomes are cellular "messaging packages" containing proteins and signalling molecules that facilitate cell-to-cell communication. They are theorised to deliver regenerative signals that modulate inflammation and promote healing [cite: 236-238].

Regulatory Status: This is strictly an investigational treatment. We only discuss this where there is a clear clinical rationale, with full transparency about the lack of long-term data and current UK regulatory considerations [cite: 240-243].

Regular use of vaginal moisturisers (2-3 times weekly, not just before sex) helps maintain baseline hydration. Use water-based lubricants during intimacy to reduce friction. Avoid perfumed products, harsh soaps, douching, or tight synthetic clothing. Staying hydrated and maintaining regular sexual activity (where comfortable) also supports tissue elasticity ("use it or lose it" principle).

• "It's just part of ageing": False. Symptoms are treatable, not something you must endure.
• "Only old women get it": False. It affects younger women after surgical menopause, breastfeeding, or cancer treatment.
• "Lubricant solves the problem": False. Lubricants reduce friction but don't fix underlying tissue thinning or pH changes.
• "It means you're not aroused": False. Arousal is different from tissue health; even aroused tissues can remain dry and fragile.

The burden is often hidden. Pain during sex can cause relationship strain and anxiety. Persistent burning or urinary urgency can interfere with work, exercise, and social confidence. Many women delay seeking help due to embarrassment, but your symptoms are real, valid, and treatable.