Considering the importance, prevalence and high complications of sexual function disorders due to genitourinary syndrome and the complications of existing treatments[1,2], this study aims to determine the effect of fractional carbon dioxide laser on the sexual function of women with genitourinary syndrome.

In this semi-experimental study, 160 women underwent vaginal laser therapy with fractional carbon dioxide laser referring to our hospital during the year 2019-23, if they met the entry criteria, they were selected in an easy or accessible way. Women's Sexual Function Index (FSFI) questionnaire was completed and compared once before and once 3 months after the last laser treatment.

In this study, 160 women with a mean and standard deviation of age of 55.58 ± 11.06 years (72.5% middle-aged, 72.5% postmenopausal, and 60.0% with VVA) were included. The number of times of laser therapy was equal to 1.96 ± 0.74 sessions. 
The score of the sexual function questionnaire in patients after laser treatment compared to before was (25.3 ± 6.90 vs. 18.4 ± 7.71 ,P < 0.001), the prevalence of normal sexual function status was (40.0% vs. 15.0% respectively , P < 0.001) and the scores of patients in all dimensions of the sexual function questionnaire was higher with a significant difference( P <0.001).
There was a significant relationship between sexual performance score with age (P < 0.001), menstrual status (P < 0.001), VVA (P < 0.001) and number of laser therapy sessions (P = 0.002 and R = 0.239).

Regarding the components related to sexual performance, the results of this study showed that laser therapy had improved all six components of sexual performance (sexual desire, stimulation, moisturising, satisfaction and pain). In the same context, Adabi et al. (2020) in Iran showed that as a result of laser treatment, scores related to sexual function and also related components, including: sexual satisfaction and sexual excitability, increased [3].

Fractional carbon dioxide laser has good efficiency and high safety in improving the sexual performance of women with genitourinary syndrome and its related components.

1.Cagnacci A, Carbone MM, Palma F. Prevalence and association between objective signs and subjective symptoms of vaginal atrophy: the AGATA study. Menopause 2016; 23(10): 1139-1145.
2.Salvatore S, Nappi R, Zerbinati N, Calligaro A, Ferrero S, Origoni M, et al. A 12-week treatment with fractional CO2 laser for vulvovaginal atrophy: a pilot study. Climacteric 2014; 17(4): 363-9.
24.	Adabi K, Golshahi F, Niroomansh S, Razzaghi Z, Ghaemi M. Effect of the Fractional CO2 Laser on the quality of life, general health, and genitourinary symptoms in postmenopausal women with vaginal atrophy: a prospective cohort. Journal of Lasers in Medical Sciences 2020; 11(1): 65.