A randomized prospective pilot study reported that High intensity laser therapy (HILT) was  effective in treating women with provoked vestibulodynia (PVD). M. Morin et al. aimed to evaluate the acceptability and feasibility of HILT in women with PVD along with the effects of sham and active HILT on intensity of pain during sexual intercourse.

In total, 40 women (aged 18–45) were included with PVD who experienced pain for more than three months at the entrance of the vagina during vaginal intercourse, with an intensity of ≥5 on a numerical rating scale (NRS). For 6 weeks, women were randomly assigned to receive sessions two times a week of either active (n = 20) or sham (n = 20) HILT. At baseline and following two weeks of therapy, women were examined. As measures of acceptability and practicality, the attendance rate at laser sessions (≥80% of participants attended ≥10 sessions), the dropout rate (<15%), as well as the lack of major adverse events, were used. 

Subjective satisfaction and improvement in patients were also evaluated. The impact of treatment on mean pain intensity during intercourse was examined. Only 1 volunteer in the active HILT group withdrew from the research at the end of therapy because of time restraints. With the exception of two volunteers who had 11 sessions due to COVID-associated issues, all participants attended all 12 of the scheduled therapy sessions.

No severe adverse effects were recorded. In terms of Patients’Global Impression of Change (PGIC), significant improvements were recorded in 79% of women in the active HILT group and 47% in the sham group. Notably, 10% of women in the sham group reported their conditions getting worse. Women included in the active group reported higher levels of treatment satisfaction, with a mean of 6.6/10 (Standard deviation [SD] 2.8) in comparison with a mean of 4.6/10 (SD 3.1) in the sham group.

Women in the active HILT group and sham HILT group experienced a substantial decrease in pain intensity from baseline to post-treatment, as shown in Table 1:

Hence, HILT appears to be an acceptable and feasible intervention to treat PVD. Additional trials must be conducted to substantiate the efficacy of HILT as a promising intervention for vulvodynia management.