Inclusion Criteria:  Women over 40 years of age Patients with natural menopause or menopause secondary to cancer treatment (breast, pelvis or other) Patients with vaginal and/or urinary, non-vulvar GSM Patients for whom CO2 laser therapy is proposed  Exclusion Criteria:  Vulvovaginal infections (vaginosis) Uninvestigated vaginal hemorrhage Herpes Pregnancy or breastfeeding Cervico-vaginal pathology (cervical and/or vaginal dysplasia) Suspected or diagnosed HPV Significant vaginal prolapse Patients on hormone replacement therapy