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Cleveland Clinic will serve as the central Data Coordinating Center Study Identification and Recruitment Potential subjects will be identified by members of the sections of Urogynecology and Reconstructive Pelvic Surgery and Benign Gynecology at the respective institutions. Eligible patients who agree to participate will be provided written informed consent administered by the collaborators listed on this IRB. Randomization The participants will then be randomized to either fractional CO2 vaginal laser therapy or vaginal estrogen cream winsstonsalem to a computer-generated randomization schedule with random block sizes with the use of the SAS statistical software package SAS Institute, Cary, NC. All patients will be unblinded to their asment. Completion of these questionnaires should take no more than minutes. A vaginal maturation index will be obtained at the baseline visit on a regular Pap Smear side and fixed with cytofixative and air dried.

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