
The study aimed to assess the impact of CO2 laser and estrogen treatments on vaginal microbiota in genitourinary syndrome of menopause (GSM) patients. Sixty-four participants were divided into estrogen, CO2 laser, and control groups. Both treatments decreased alpha diversity in vaginal flora, enhancing beneficial bacteria. Vaginal health and voiding function improved in both groups after 3 months, with sustained benefits in the CO2 laser group at 12 months. Pathological evaluations revealed improved vaginal health, with CO2 laser therapy showing superior long-term efficacy over estrogen.
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