Combination of photodynamic therapy and estrogen cream for menopause women with cervical low-grade squamous intraepithelial lesion with human papillomavirus infection

In menopausal women, decreased estrogen levels lead to genital tract mucosal atrophy and reduced mucosal immune function. Low-grade squamous intraepithelial lesions (LSIL) associated with persistent or newly acquired high-risk HPV infection may progress silently to high-grade squamous intraepithelial lesions (HSIL) and eventually cervical cancer. This study aimed to evaluate the efficacy and safety of photodynamic therapy combined with estrogen in the treatment of menopausal women with LSIL and high-risk HPV infection. A retrospective controlled study was conducted to compare LSIL regression and HPV clearance among three treatment groups: photodynamic therapy plus estrogen, interferon gel plus estrogen, and estrogen alone. Therapeutic outcomes were assessed using ThinPrep cytology (TCT), HPV testing, and colposcopic pathology at 3, 6, and 12 months post-treatment. The rates of LSIL regression and HPV clearance in the photodynamic therapy plus estrogen group were significantly higher than those in both the interferon gel plus estrogen group and the estrogen-alone group at 3, 6, and 12 months (p < 0.05). Furthermore, the interferon gel plus estrogen group showed improved outcomes compared to estrogen alone, with statistically significant differences (p < 0.05). Photodynamic therapy combined with estrogen cream is an effective and safe treatment approach for menopausal women with LSIL and high-risk HPV infection.