Fractional Bipolar Radiofrequency Therapy VS Sham for Treatment of Vaginal Laxity in Premenopausal Women

The Vaginal Laxity Questionnaire (VLQ)

Subjective outcomes * The Vaginal Laxity Questionnaire (VLQ) will be used to assess patient-reported vaginal laxity. * A score of 1-3 indicates positive for vaginal laxity (1 = severe, 2 = moderate, 3 = mild symptom). * A score of 4-7 indicates no vaginal laxity, with 7 representing the greatest vaginal tightness. * A higher VLQ score post-treatment reflects improvement in vaginal laxity.

Subjective outcomes: The Patient Global Impression of Improvement (PGI-I)

The Patient Global Impression of Improvement (PGI-I) will measure overall patient satisfaction with treatment outcomes. It is a global index used to assess the response of vaginal laxity to therapy. The PGI-I is a single-question transition scale asking patients to rate their vaginal laxity condition compared to before treatment, on a scale from 1 (very much better) to 7 (very much worse).

Subjective outcome: Patient-reported adverse events

Patients will report any side effects or adverse events experienced during the study. * Pain or discomfort will be assessed using "a visual analog scale" from 0 to 10 (0 = no pain, 10 = worst pain). * Other adverse events, such as abnormal vaginal bleeding, abnormal vaginal discharge, vaginal burning sensation, and dyspareunia, will be reported as yes (if present) or no (if not present)

Subjective outcome: The Thai version of the Female Sexual Function Index (FSFI)

The FSFI comprises of a 19-item questionnaire focused on sexual functioning. There are 6 domain scores (desire, arousal, lubrication, orgasm, satisfaction, pain) belonging to the FSFI and that are summed to obtain the overall score. The rule of thumb for the overall result is that scores equal to or below 26.55 are classed as indicating female sexual dysfunction (FSD). The domain scores are derived from the multiplication of the sum of domain items points and the domain factor. By adding the six domains, the final result can be obtained. Usually, for domains in which the score is zero, this is indicative of the subject having reported there was no sexual activity during the past 4 weeks.

Subjective outcome: The Thai version of the Female Genital Self-Image Scale (FGSIS)

The FGSIS score stands for the Female Genital Self-Image Scale. It is used to assess how women perceive their genitalia and can provide insight into their satisfaction, body image, and how these factors may impact sexual function and health-related quality of life. The FGSIS includes a series of statements or questions, usually answered on a 4-point or 5-point Likert scale, with responses such as: * Strongly Disagree * Disagree * Neutral * Agree * Strongly Agree Total Score: • The responses are totaled to give an overall score. Interpretation of Scores: * Low Scores: These suggest a more negative or dissatisfied genital self-image. This may reflect concerns or dissatisfaction with the appearance, function, or health of the genital area, which could be related to emotional or sexual concerns. * High Scores: Higher scores indicate a more positive or satisfied genital self-image, suggesting greater confidence or comfort with one's body in this regard.