Improvement of signs of vulvovaginal chronic graft-versus-host disease and genital syndrome of menopause with non-ablative radiofrequency therapy

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Chronic graft-versus-host disease (cGVHD) is a major cause of late morbidity and mortality following allogeneic hematopoietic cell transplantation (allo-HCT), affecting ~40 to 70% of patients [1]. Frequent gynecological complications following allo-HCT include vulvovaginal cGVHD and genitourinary syndrome of menopause (GSM) [2]. Non-ablative radiofrequency (NARF) therapy has shown beneficial effects in managing GSM [3] and tissue scarring [4]. However, there are no published reports evaluating its use in vulvovaginal manifestations of vulvovaginal cGVHD. Herein, we report a case series using NARF in female allo-HCT survivors.

Vulvovaginal NARF therapy works by delivering electromagnetic energy to targeted tissues, which stimulates collagen production and remodeling through increased angiogenesis, fibroblast activation, and reorganization of the extracellular matrix. These processes promote tissue regeneration and induce cellular differentiation, resulting in improved structural and functional outcomes [4, 5].