Photobiomodulation and pelvic floor training for genitourinary syndrome: RCT results.

OBJECTIVE: This study aimed to evaluate the effects of photobiomodulation (PBM) alone and in combination with pelvic floor muscle training (PFMT) on pelvic floor muscle (PFM) function, sexual and urinary function, and quality of life in women with genitourinary syndrome of menopause. METHOD: The three-arm clinical trial included women aged 45-65 years who had experienced natural menopause for at least 1 year. Participants were randomized into three groups: PFMT + active PBM, PFMT + sham PBM and isolated PFMT. Interventions lasted 8 weeks, with participants attending two 50-min sessions per week. Outcomes were assessed before and after the 16th session. RESULTS: Although manometry showed no significant differences between groups, the intervention group demonstrated greater numerical improvement. The Female Sexual Function Index (FSFI) total score differed significantly between the PFMT + active PBM and PFMT + sham PBM groups (mean difference = 4.55; 95% confidence interval: 0.57, 8.52; d = 1.05). Significant between-group differences were also observed in the orgasm subdomain in favor of the PFMT + active PBM group compared to the PFMT + sham PBM group. The International Consultation on Incontinence Questionnaire - short form (ICIQ-SF) indicated a clinically significant improvement of 3.06 points in the PFMT + active PBM group compared to the PFMT + sham PBM group following the intervention. CONCLUSION: Active PBM combined with PFMT showed greater but non-significant improvements in PFM pressure, urinary function and quality of life, while significantly improving only sexual function.