Treatment of genitourinary menopausal syndrome with a drug based on hyaluronic acid
Authors:   National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Kazakova S.N. ,   Moscow, Russian Federation, Apolikhina I.A. ,   Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University); Moscow, Russian Federation,   National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov; Moscow, Russian Federation, Teterina T.A. ,   National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov; Moscow, Russian Federation, Bychkova A.E. ,   National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov; Moscow, Russian Federation, Saidova A.S. ,   National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov; Moscow, Russian Federation
Published: May 2024

Aim. To evaluate the effectiveness and safety of the injection of a hyaluronic acid-based drug for the treatment of symptoms of vulvovaginal atrophy (VVA) in postmenopausal women. Design. Prospective intervention study. Materials and methods. The study included 66 women aged 36 to 60 years (average age — 49.3 ± 3.6 years) with symptoms of VVA, who had menopause (including surgical) for more than 12 months. All patients were injected with a hyaluronic acid-based drug 20 mg/ml in a volume of 2 ml into the lower third of the vaginal mucosa, posterior adhesions, vaginal vestibule and labia majora. The evaluation of the effectiveness of treatment was carried out on the basis of gynecological examination data, evaluation of the index of vaginal health. All patients were surveyed before and 1, 3 and 6 months after the procedure based on validated questionnaires: the index of female sexual function (FSFI), the visual analog scale (VAS) of overall satisfaction with treatment. Results. After injection of hyaluronic acid into the perineovaginal area to correct the symptoms of VVA, the indicators of index of vaginal health improved, and atrophy decreased from severe to moderate. According to the survey data, all patients (n = 66) showed an increase in such FSFI indicators as hydration (by 65%), satisfaction (by 34%), desire (by 10%), and increased orgasm (by 30%). Symptoms of dyspareunia tended to decrease: patients noted a decrease in pain up to 15% (according to the FSFI questionnaire). In 38 (58%) women, an improvement in the aesthetic appearance of the vulva and perineum was recorded (VAS — from 4.3 to 7.5 points). After the intervention, not a single case of allergic reactions or infectious complications was recorded. Conclusion. The presented alternative approach to IVA therapy in women has demonstrated its effectiveness. Its use can improve the quality of life and contribute to the achievement of family and physical well-being of women, reduce the degree of atrophy from severe to moderate. Injection of drugs based on stabilized hyaluronic acid in patients with BBA has high therapeutic significance and can be widely used in practical healthcare. Taking into account the minimally invasive nature of the procedure and the long-term effect (up to 9–12 months), this method can be recommended for widespread implementation in the work of women's consultations. Key words: hyaluronic acid, vulvovaginal atrophy, genitourinary menopausal syndrome, dyspareunia.