PATIENTS AND METHODS: A randomized single-blind sham-controlled trial was conducted. 31 postmenopausal women with Vaginal Maturation Value (VMV <
50%) were randomized into laser or sham intervention groups, receiving three monthly treatments. VMV, vaginal pH, and GSM symptoms severity were measured at 3- and 9-months post-intervention, and AE were assessed. RESULTS: 27 patients completed the study
14 were randomly assigned to the laser and 13 to the sham group. At 3 months, VMV improved by 12.4% compared to the sham group (P= 0.033), indicating a significant reversal of VA and a significant patient global improvement (P=0.030). At 9 months, dyspareunia decreased significantly (P = 0.049), while other symptoms and patient satisfaction demonstrated a significant improvement trend. However, VMV in the laser group returned to baseline values. Vaginal pH remained unchanged. The laser intervention was well tolerated, with mild and self-limited AEs. CONCLUSION: The mixed wavelength laser enables a reduction of 10,600 nm laser power, enhancing its safety profile while achieving promising outcomes in GSM. It is a safe, well-tolerated, and effective alternative for GSM treatment when conventional therapies fail. Further studies with larger samples, varied settings, and extended follow-up are needed to assess its long-term efficacy and side effects.