Use of Fractional CO2 Laser Versus Erbium:YAG Laser for the Treatment of GSM in Patients Using Aromatase Inhibitors

Inclusion Criteria: Recruited participants will meet all of these criteria: * a history of breast cancer * premenopausal at diagnosis of breast cancer * using AI as an adjuvant treatment * moderate to severe symptoms of GSM (VAS ≥ 4/10) * currently menopausal, which can be either biochemical menopause as confirmed after chemotherapy, surgical or medicinally induced (GnRH analogues for the duration of the trial) Exclusion Criteria: * Not willing to abstain from vaginal intercourse for 1 week following laser therapy * Use of non-hormonal vaginal preparations within the last 6 weeks before inclusion * Use of hormonal therapy within 6 months prior to inclusion (systemic or local) * Acute urinary or genital tract infections * A history of genital fistula, a thin rectovaginal septum as determined by the investigator, or history of fourth degree laceration * Prolapse ≥ grade 2 according to the Pelvic Organ Prolapse Quantification System * Previous vaginal mesh implantation * Abnormal result in the last cervical smear (maximum 36 month before enrollment) * Active cancer treatment (radiotherapy or chemotherapy) ongoing or planned prior to the measurement of the primary outcome (6 months after inclusion, 3 months after last laser) * Vaginal stenosis that does not allow the placement of the laser probe * Any condition that could interfere with study compliance