How does RLT help?
Red light therapy seems to have numerous ways it can assist with various women's health issues. That includes, but is not limited to, helping reduce tension in smooth muscle (i.e., dysmenorrhea); enhanced systemic blood flow (i.e., infertility); chemical & mechanical changes, along with modulated inflammation (i.e., endometriosis); and promote lymph vessel regeneration, improve lymphatic motility & reduce tissue fibrosis (i.e., breast cancer-related lymphedema).
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Breast Cancer-Related Lymphedema
A considerable number of breast cancer survivors suﬀer from secondary lymphedema due to cancer related treatments (surgery and/or radiation therapy). Despite eﬀorts to reduce lymphedema rates with new surgical techniques, the axillary dissection as a standard for clinically node negative patients, breast cancer-related lymphedema (BCRL) remains a relevant concern. A recent systematic review estimated that more than one out of ﬁve women who survive breast cancer are aﬀected by BCRL, which has a signiﬁcant impact on breast cancer survivors, including declined physical function and increased disability, which negatively aﬀects quality of life.
Over the past two decades, photobiomodulation (i.e., red light therapy [RLT]) has been promoted and researched for the management of BCRL. RLT has been used to reduce inﬂammation, promote lymph vessel regeneration, improve lymphatic motility and prevent tissue ﬁbrosis.
The aforementioned primary reactions stimulate a cascade of secondary reactions at cellular level involving intracellular signaling and leading to stimulation of cytokine reactions and nitric oxide (NO) production; release of growth factors; up-regulation of ATP, and increased metabolism, changes in REDOX signaling, increased reactive oxygen species (ROS) and therefore cell proliferation.
Based upon a 2017 systematic review, RLT in the management of BCRL is more eﬀective for limb edema reduction than sham and no treatment at a short-term follow-up, and not more eﬀective than other conventional treatments. Data suggest that RLT may be an eﬀective treatment approach for women with BCRL.
Dysmenorrhea is the most common gynecologic disorder among female adolescents, with a prevalence of 60 - 89.5%. Common dysmenorrhea symptoms are tension, irritability, depression, anxiety, bloating, abdominal cramps, breast tenderness, joint pain and headache.
Even though dysmenorrhea has been well deﬁned, the cause of dysmenorrhea has not yet been well elucidated. Dysmenorrhea is closely associated with poor contractile pattern of the uterine muscle.
Prostaglandins are important stimulators of uterine contractility. Excess production of endometrial prostaglandin may be one of main cause of dysmenorrhea. Women with dysmenorrhea have high blood levels of prostaglandins, which are known to cause cramping abdominal pain strong uterine contractions, and temporarily reducing or stopping the blood supply to the uterus, thus depriving the uterus of oxygen resulting in contractions and pain.
Many dysmenorrhea treatment methods have been tried, and the most commonly used one is administration of non-steroidal anti-inﬂammatory drugs (NSAIDs), which are associated with a number of negative side eﬀects. However, red light therapy may be a non-invasive, safe option to help reduce symptoms related to dysmenorrhea.
A 2011 study with 31 subjects demonstrated that all women who underwent active RLT treatment showed a 50% reduction in pain scores during the ﬁrst or second menstrual cycles after active RLT treatment. The ﬁnding from this study suggests that smooth muscles in the uterus might be relaxed enough to restore normal smooth muscle function through extended light dose (they used red light only in this study). This research proposes that the abnormal function of parts of smooth muscles in the uterus secondary to long-term deﬁcient blood supply into smooth muscle tissue caused by disease or stress.
Endometriosis is present in about 10% of women of reproductive age, with the incidence increasing in middle-aged women. The spectrum of possible symptoms is wide and may include dysmenorrhea, dyspareunia, chronic pelvic pain, and pain related to ovulation. It can result in fatigue, infertility, abnormal bleeding from the uterus, and problems with the bladder and bowel.
It also has negative eﬀects on quality of life, impacting on social life, and work as well as on reproduction and ability to have a family. Additional symptoms which may develop include allergies, ﬁbromyalgia, asthma, eczema, autoimmune inﬂammatory disease, chronic fatigue syndrome, and hypothyroidism, as well as in women diagnosed with the disease after the age of 40, an increased risk of breast cancer due to prolonged exposure to raised levels of endogenous estrogen.
Treatment goals for endometriosis include pain alleviation, preserving fertility and minimizing adhesions. The most common reason for a woman to seek treatment is pain alleviation. Retrospective ﬁndings show poor long-term symptom reduction from the medical and surgical treatments commonly available, and each is associated with numerous side eﬀects.
Red light therapy is quick to reduce inﬂammation and painful symptoms. A 2018 study found that pulsed high-intensity laser therapy (HILT) utilizing near-infrared light showed that the HILT group experienced a statistically signiﬁcant decrease in severity of pain and adhesions, with a highly statistically signiﬁcant improvement in their quality of life.
What does the research show?
“In this cohort, transvaginal PBM resulted in improvement of pelvic pain without serious adverse events.” (1)
“Transvaginal PBM provided significant and sustained pain relief to women with chronic pelvic pain up to 6 months.” (2)
“Before the course of treatment began, most the RLT group members felt severe pain or unbearable pain (90%). This was signiﬁcantly reduced after treatment, with the majority of participants reporting no or mild pain (85%). In conclusion, high-intensity laser therapy is eﬀective in treating and reducing endometriosis symptoms and in improving patients' quality of life.”(3)
“All 21 participants in the active LLLT group reported either complete pain relief or signiﬁcant reduction in pain of their dysmenorrhea. All women who underwent active LLLT showed a 50% reduction in VAS (visual analog scale) scores during the 1st or 2nd menstrual cycles after active LLLT treatment (clinically signiﬁcant).” (4)
“LLLT for women with severe infertility has been shown to have what is really surprising success with a pregnancy rate of 21.7% after at least 4 years of failure with other ART (assisted reproductive technology) methods, and a successful birth rate in over half of those pregnancies.” (5)
“In conclusion, HILT (i.e., RLT) is eﬀective in treating and reducing endometriosis symptoms and in improving patients’ quality of life. It is suitable for use as an alternative conservative therapy to current medications, which are associated with numerous side eﬀects.” (6)
**While the current scientific research seems to indicate many positive benefits of RLT in relation to women's health, there is still an appreciable necessity for more extensive research to be conducted in this area, including double-blind RCT (randomized controlled trials), to provide a more comprehensive, robust overview that will further elucidate the optimal parameters and appropriate uses of RLT, which will ultimately lead the most safe & efficacious uses for those dealing with women's health issues.
(1) Kohli, Neeraj et al. “An observational cohort study of pelvic floor photobiomodulation for treatment of chronic pelvic pain.” Journal of comparative effectiveness research vol. 10,17 (2021): 1291-1299. doi:10.2217/cer-2021-0187
(2) Zipper, Ralph et al. “Transvaginal Photobiomodulation for the Treatment of Chronic Pelvic Pain: A Pilot Study.” Women's health reports (New Rochelle, N.Y.) vol. 2,1 518-527. 23 Nov. 2021, doi:10.1089/whr.2021.0097
(3) Thabet AAE, Alshehri MA. Eﬀect of Pulsed High-Intensity Laser Therapy on Pain, Adhesions, and Quality of Life in Women Having Endometriosis: A Randomized Controlled Trial. Photomed Laser Surg. 2018;36(7):363-369. doi:10.1089/pho.2017.4419
(4) Shin YI, Kim NG, Park KJ, Kim DW, Hong GY, Shin BC. Skin adhesive low-level light therapy for dysmenorrhoea: a randomized, double-blind, placebo-controlled, pilot trial. Arch Gynecol Obstet. 2012;286(4):947-952. doi:10.1007/s00404-012-2380-
(5) Ohshiro T. Personal Overview of the Application of LLLT in Severely Infertile Japanese Females. Laser Ther. 2012;21(2):97-103. doi:10.5978/islsm.12-OR-05
(6) Thabet, Ali Abd El-Monsif, and Mansour Abdullah Alshehri. “Eﬀect of Pulsed High-Intensity Laser Therapy on Pain, Adhesions, and Quality of Life in Women Having Endometriosis: A Randomized Controlled Trial.” Photomedicine and laser surgery vol. 36,7 (2018): 363-369. doi:10.1089/pho.2017.4419