Abstract
ABSTRACTObjectiveTo evaluate the clinical response of patients with symptoms of genitourinary syndrome of menopause after application of microablative fractional radiofrequency in the vagina and vaginal introitus.MethodsFourteen patients with symptoms of genitourinary syndrome of menopause underwent three applications of microablative fractional radiofrequency with a 30-day interval, using the Wavetronic 6000HF-FRAXX device and a fractional vaginal electrode. The questionnaires World Health Organization Quality of Life (for quality of life evaluation), Female Sexual Function Index and Quality of Life Adapted Questionnaire in the Domain of Sexual Satisfaction (for sexual function and satisfaction evaluation) were administered before and after the applications (30 to 60 days after the last procedure), in addition to the satisfaction questionnaire after procedure.ResultsThere was an increase in almost all dimensions on average in quality of life, with statistical significance only in the health domain. There was a significant improvement in the sexual domains in almost all dimensions. All patients stopped using lubricant during intercourse after treatment. In the satisfaction questionnaire after treatment, we observed that the vast majority felt cured or much better (29% and 64%, respectively, total of 92.6%) and were very satisfied or satisfied (43 and 57%, respectively, total of 100%). The only patient who reported little improvement had an 18-year postmenopausal history and was treatment naïve.ConclusionMicroablative fractional radiofrequency was effective in treating symptoms of vaginal dryness and dyspareunia, and eliminated the use of vaginal lubricant during the period observed. Since this is a pilot study with a small number of patients, further studies are required to corroborate our findings and evaluate the long-term effects of microablative fractional radiofrequency on the vaginal tissue.
Highlights
The term “vulvovaginal atrophy” (VVA) is frequently used to describe symptoms resulting from decreased estrogen and other sexual steroids levels, which are common within the climateric syndrome, comprising vulvar, vaginal, urethral and bladder changes
The term “genitourinary syndrome of menopause” (GSM) has been gaining notoriety since 2012, when the board of the International Society for the Study of Women’s Sexual Health (ISSWSH) and the administration board of the North American Menopause Society (NAMS) acknowledged the need to review the terminology for VVA, considering the genitourinary symptoms during the postmenopausal period.[1,2]
Hypoestrogenism can occur in other situations, such as surgical menopause, or the use of gonadotropinreleasing hormone (GnRH) agonist; in hypothalamic amenorrhea due to excessive exercise, and eating disorders
Summary
The term “vulvovaginal atrophy” (VVA) is frequently used to describe symptoms resulting from decreased estrogen and other sexual steroids levels, which are common within the climateric syndrome, comprising vulvar, vaginal, urethral and bladder changes. The term “genitourinary syndrome of menopause” (GSM) has been gaining notoriety since 2012, when the board of the International Society for the Study of Women’s Sexual Health (ISSWSH) and the administration board of the North American Menopause Society (NAMS) acknowledged the need to review the terminology for VVA, considering the genitourinary symptoms during the postmenopausal period.[1,2]. GSM may include, but is not limited to, genital symptoms such as vulvar vestibule and vaginal dryness, burning sensation, discomfort, and vulvovaginal irritation, in addition to sexual symptoms, such as lack of lubrication and dyspareunia, leading to impaired intercourse, and urinary symptoms like urinary urgency, frequent urination (pollakiuria), dysuria and recurrent urinary infections.[3]. The discomfort associated with VVA can have a significant impact on the overall health and quality of life, but patients not sexually active may go through this period without experiencing most of the symptoms previously mentioned.[1,2,3,4,5,6,7]
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