Photobiomodulation for hormone therapy-induced sexual dysfunction in women with breast cancer: a prospective quasi-experimental clinical study with a parallel observational group
Vieira LR,Rezende LF
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026
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Abstract
Background
Breast cancer survivors undergoing hormone therapy frequently experience vaginal pain and sexual dysfunction, which negatively affect quality of life. These symptoms are often undertreated, and new therapeutic approaches are needed.
Purpose
To evaluate the effects of photobiomodulation (PBM) on vaginal pain, sexual function, safety, and tolerability in women with breast cancer undergoing hormone therapy.
Methods
A prospective, quasi-experimental clinical study was conducted with 24 women presenting hormone therapy-induced sexual dysfunction, who underwent four weekly intra- and extra-cavitary PBM sessions (blue LED-440 nm, 8 min; red LED-660 nm, 20 min). Eight eligible participants who declined the intervention due to embarrassment were followed as an untreated observational group. Assessments were performed before and after the intervention using the Female Sexual Quotient Questionnaire (QS-F) and the Visual Analog Scale (VAS) for vaginal pain.
Results
At baseline, 82.6% of participants reported maximum vaginal pain (VAS = 10), and 78.2% presented absent or severely impaired sexual function. After four PBM sessions, 79.1% of the women reported complete absence of pain, with mean VAS scores decreasing from 9.46 ± 0.98 to 1.04 ± 2.17 (p < 0.0001). Sexual function also improved significantly, with mean QS-F scores increasing from 23.25 ± 23.47 to 87.21 ± 17.93 (p < 0.0001), and 95.8% of participants reporting good to excellent sexual function after treatment. The intervention was well tolerated, with no adverse events reported. The observational group showed no changes in the evaluated outcomes.
Conclusion
PBM proved to be safe, well tolerated, and clinically effective in reducing vaginal pain and improving sexual function in women with breast cancer undergoing hormone therapy, representing a promising therapeutic alternative.
Anticancer treatments induce vulvovaginal complications that alter the quality of life and sexuality of patients. New technologies, such as photobiomodulation, could address this problem, for which few effective therapeutic solutions exist. The objective of this study was to describe the characteristics of patients seeking treatment and to observe the effects of photobiomodulation. This is a prospective cohort of patients treated for cancer, in failure of first-line medical treatment, managed at the University Hospital of Nîmes. The history, symptoms and impact of the disorders on their quality of life were collected. At follow-up, improvement was assessed using the PGI-I and FSFI questionnaires. Twenty-eight patients were treated. They were all menopausal, half of them after anticancer treatments [chemotherapy (78%), radiotherapy (36%), hormone therapy (36%)]. The main symptom reported was vaginal dryness (72%). Seventy-one percent of patients (n=20) felt that their daily life was affected≥8/10. All patients had sexual dysfunction. Twenty-two patients received at least 6 sessions of photobiomodulation. Seventy-two percent (n=18) of patients felt better or much better after treatment (PGI-I≤2). The median improvement estimated by the patients was 65% (Q1=50%; Q3=72.5%). There was also a significant clinical improvement. No serious adverse events were reported. Due to the small number of patients in a heterogeneous population with no control group, we cannot extrapolate our results. However, the objective was to assess the status of these pathologies and the contribution of photobiomodulation in patients who have failed first-line treatment; and these results are encouraging.
Kohli N et al., 2021·Journal of comparative effectiveness research
This research is the first to evaluate the effectiveness of trans-vaginal photobiomodulation therapy (TV-PBMT) for chronic pelvic pain. Materials & Observational analysis of 128 women, undergoing TV-PBMT for chronic pelvic pain. Minimal clinically important difference, defined as ≥2-point drop on a 0-10 numeric pain rating scale (NPRS), and effect size Cohen d coefficient, was calculated over nine treatments for overall pain, and pain with activities. Compared with baseline, 64.5% of women showed improvement in overall pain, pain with bowel movement, intercourse, exercise, urination, sitting and vulvar pain (minimal clinically important difference = -2.4, -2.0, -2.4, -2.1, -2.1, -2.0, -3.1; d = 0.9, 0.7, 0.9, 0.7, 0.7, 0.7, 0.9) by treatment 9. In this cohort, TV-PBMT resulted in improvement of pelvic pain without serious adverse events.
Zipper R et al., 2021·Women's health reports (New Rochelle, N.Y.)·Free full text on PubMed Central
Chronic pelvic pain (CPP) is a common and debilitating condition that affects millions of U.S. women. Most treatments are ineffective and innovative new therapies are desperately needed. Large, controlled studies show that photobiomodulation (PBM) can reduce pain in patients with other chronic pain conditions, such as low back pain, neck pain, and fibromyalgia. The objective of this pilot study was to determine if transvaginal PBM (TV-PBM) can reduce pain in women with CPP. We conducted a before and after, observational, pilot study. Patients completed the Short Form-McGill Pain Questionnaire (SF-MPQ) at baseline, 1 week, 3 months, and 6 months after nine treatments of TV-PBM. Clinicians completed the Clinical Global Impression Scale (CGI) assessing patient illness severity at the same time. Wilcoxon rank-sum t-tests and effect size using Cohen's d coefficient (low effect size if d < 0.2, medium if 0.2 < d > 8, and high if d > 0.8) was used to measure degree of pain improvement, which was also considered clinically significant if pain reduction was >30%. Thirteen women completed 9 treatments, and 10 women were successfully followed to 6 months. At baseline, the mean SF-MPQ score was 19.7 (standard deviation [SD] ± 5.9). Compared with baseline, 60% improved; the mean SF-MPQ score decreased to 10.0 (SD ±7.5, p = 0.004, d = 1.6) at 1 week after treatment, to 9.7 (SD ±7.9, p = 0.005, d = 1.7) at 3 months, and 8.2 (SD ±8.1, p = 0.002, d = 1.9) at 6 months. Transvaginal PBM provided significant and sustained pain relief to women with CPP up to 6 months. Further controlled studies are needed to confirm these findings, however, in this initial pilot, TV-PBM shows promise.
Interstitial Cystitis/ Bladder Pain Syndrome (IC/BPS) is characterized by pelvic/bladder pain, associated with pelvic muscle tenderness, urgency, frequency, and dysuria. Prior studies show that transvaginal photobiomodulation (TV-PBM) reduces pain in women with chronic pelvic pain (CPP). Our objective was to obtain preliminary data on treatment effect and adherence, in women with IC/BPS who selected TV-PBM therapy for management of pelvic pain. Before-and-after observational cohort study of women with IC/BPS who received TV-PBM in 17 US practices. Pain was measured using a 0-10 numeric rating scale (NRS). The primary outcome was a minimal clinical important difference (MCID); reduction of overall pelvic pain severity by ≥2 NRS points from baseline compared to after 8 treatments. Cohen d coefficient measured effect size (low effect size d<0.2, medium 0.20.8). Of 140 patients with IC/BPS who self-selected to start TV-PBM therapy, 89.3% (n=125) completed 4 treatments and 59.3% (n=83) completed 8. Improvement ≥1 NRS point was reported by 73.5% (n=61) and meaningful improvement (≥2 points) was reported by 63.9% (n=53) after 8 treatments. In this group, patients with severe / moderate pain decreased from 83.1% (n=44) to 38.5% (n=20); p<0.001. Pain levels decreased as follows: overall pelvic pain MCID=-2.7, d=1.07, pain with urination MCID=-2.6, d=1.0; pain with exercise MCID=-2.6, d=0.91, pain with intercourse MCID=-2.5, d=0.82. In real-world clinical settings, 2/3 women with IC/BPS who opted to undergo TV-PBM therapy reported significant decrease in pelvic pain and dysuria. These findings are promising; however, controlled studies are needed.
Sexual Health › Sexual Function › Arousal and Orgasm · Therapeutics › Emerging Therapies › Light Therapy · General Gynecology › Breast Health › Breast Cancer Risk
Lara Resende Vieira, Laura Ferreira Rezende
L Vieira, L Rezende
PMID 42228167 42228167 DOI 10.1007/s00520-026-10846-0 10.1007/s00520-026-10846-0 Vieira et al. 2026, Vieira 2026