Abstract
The aim of this study was to evaluate the effectiveness of low molecular weight hyaluronic acid oral tablets for the treatment of atrophic vaginitis. 12 women with atrophic vaginitis were recruited for this double blind, placebo-controlled study. Patients were randomized to receive either low molecular weight hyaluronic acid (HA) oral tablets or placebo for three months. Vaginal biopsies were taken at baseline and after three months of treatment, and vaginal epithelium was analysed using light microscopy. The evaluation of symptoms was self-assessed by the patients. Biopsies from HA group showed an epithelium thicker than in placebo group. The lamina propria from the HA group also showed a denser appearance compared to placebo group. Morphometric analysis showed significant differences between HA and baseline in the number of epithelial layers and in the thickness. The evaluation of symptoms also showed an effective improvement in the patients treated with HA, compared to baseline and to placebo group. In conclusion, oral administration of HA tablets improved the vaginal epithelium, decreasing atrophy. This can be an ideal option for patients with atrophic vaginitis who do not want to or can not take estrogen and show low compliance toward vaginal administration.
Highlights
Cross-sectional studies provide strong evidence that sexual activities and sexual function decline with age
Minozzi and colleagues performed an open multicentric longitudinal study to evaluate the efficacy of oral administration of Hyaluronic Acid (HA), administered in a low molecular weight pharmaceutical form, in postmenopausal patients suffering of atrophic vaginitis [17]
The results of this study showed that HA administration improved vaginal atrophy already after one month of treatment, and that it slowed the physiological aging of vulvar and vaginal tissues, increasing their hydration rate [17]
Summary
Cross-sectional studies provide strong evidence that sexual activities and sexual function decline with age. Topical estrogenic products have been developed to minimize the systemic adverse effects of the oral hormone replacement therapy, they cannot yet be considered as risk-free alternative in case of prolonged use [13], promoting an active search for different and somehow innovative therapies Among these, both daily intravaginally administered testosterone or dehydroepiandrosterone (DHEA) have been proposed for the treatment of vaginal atrophy [14]. On the basis of these preliminary results and in order to reduce the use of hormonal therapy, given the cancer risk, the aim of the present study was to evaluate in a double blind, placebo-controlled trial whether HA, orally administered in a low-molecular weight oral formulation.This alternative therapy could ameliorate vaginal atrophy, improving the symptoms and modifying the vaginal epithelium in postmenopausal women, without side effects and particular risks for the women’s health
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