The short answer
Neither option can be recommended for every woman, and the research does not settle which one suits whom. Laser tends to be discussed where dryness or thinning is part of the picture. Radiofrequency tends to be discussed for laxity after childbirth. An examination decides. Some women need one, some both, and some neither.
Before either device, it helps to ask whether a simpler step would do. Results vary with both, and a device may not change your symptoms.
Try these before any device
They ease the surface and reduce friction. They do not change lining thickness or laxity.
It supports the lining where low oestrogen drives thinning. It needs a doctor's assessment and prescription, and it does not treat stretched tissue.
It strengthens the muscles that support the bladder, vagina and bowel, ideally guided by a women's health physiotherapist. See our pelvic floor guide.
Vaginal laser or radiofrequency: how they differ
| Feature | Fractional CO2 laser (G Lift) | Monopolar radiofrequency (GF Lift) |
|---|---|---|
| Energy | 10,600 nm laser in a microablative pattern | Electrical current on the Volnewmer platform |
| Zones | Vaginal lining and opening | Vaginal canal, opening, outer labia and mons |
| Surface | Micro-columns that heal from the tissue between them | Left intact |
| Often discussed for | Laxity with dryness or thinning, often around menopause | Laxity after childbirth; loose outer labia |
| Evidence in brief | Mixed; one sham trial found no significant benefit at 12 months | Mixed; results depend on device and measure |
| Cannot do | Strengthen the pelvic floor or correct prolapse | Strengthen the pelvic floor or correct prolapse |
How each one aims to work
Fractional CO2 laser makes tiny micro-ablative columns in the lining, with heat around them, to prompt collagen remodelling. Radiofrequency heats tissue through electrical resistance, not laser light, and aims at tissue contraction and new collagen over several weeks. With radiofrequency, nothing is injected, implanted or cut. These are aims, not promises. Neither replaces pelvic floor physiotherapy.
The 2018 FDA caution
In 2018 the US Food and Drug Administration warned about energy-based devices marketed for vaginal rejuvenation. It stated it had not evaluated these devices for those uses. It reported cases of vaginal burns, scarring, painful intercourse and chronic pain, and sent notices to seven manufacturers. The same year, the International Society for the Study of Vulvovaginal Disease (ISSVD) and the International Continence Society (ICS) recommended against using laser and radiofrequency for vulvovaginal atrophy. They added that the devices should not be used for lichen sclerosus, vulvodynia, urinary incontinence or rejuvenation outside properly designed clinical trials. In 2021, ACOG stated that laser is neither FDA-approved nor FDA-cleared for symptoms related to menopause, and said more research is needed before recommending it.
What the laser studies found
In 85 women randomised to fractional CO2 laser or sham, laser did not significantly improve vaginal symptoms after 12 months compared with sham.
In six randomised trials with 270 women, CO2 laser was associated with similar improvement in genitourinary symptoms as vaginal oestrogen, with no significant differences on the main measures.
What the radiofrequency studies found
In this sham-controlled trial, more women in the active group reported no laxity at six months. A subanalysis of 108 premenopausal women, with authors tied to the manufacturer, found greater six-month improvement in arousal, lubrication and orgasm scores.
This later, larger sham-controlled trial did not meet its main sexual function goal at 12 months.
In 76 women, laxity improved more with active treatment than sham at 4, 6 and 12 months. Sexual function scores did not improve significantly more than sham at all visits.
These trials tested other devices, so they do not prove results for GF Lift.
How to read this evidence
Keep three points in mind. First, a result with one device may not apply to another. Second, a study may show change on one measure and not on another, as the 2024 trial did. Third, some research has manufacturer links, and that should be stated. Most published studies are small, and sham-controlled trials have given mixed results. Our sources do not support a claim that either energy is more effective than the other for laxity. Our evidence library lists more papers.
Who should avoid either device
Pregnancy, active infection, undiagnosed bleeding, an abnormal cervical screen still being followed up, and prolapse or pelvic floor weakness that needs other care first.
Treatment waits until healing is complete.
A pacemaker, a defibrillator, or a metal implant near the area.
Breastfeeding is discussed first. Pelvic mesh or implants and recent pelvic surgery or radiotherapy are assessed individually.
Risks with either device
Warmth or light vibration can be felt during treatment. Mild discharge, spotting, irritation or tenderness can follow laser. Burn, scarring, infection and painful sex can occur, and true rates are unknown, and the FDA reported burns, scarring, painful intercourse and chronic pain with energy devices. The FDA has said these devices carry serious risks and lack adequate evidence for this use. The sham-controlled trial by Li and colleagues used MonaLisa Touch, the laser system used for the G Lift. Report unusual pain, discharge, bleeding or blistering promptly. Fees for GF Lift and G Lift are given in writing after examination, and no treatment stays an option.