Use of platelet-rich plasma for the treatment of dyspareunia in postmenopausal women

Abstract

To evaluate the effectiveness of the use of Platelet-rich Plasma (PRP) for the treatment of dyspareunia in postmenopausal women. A psychological, sexological and gynaecological examination of 52 women aged from 45 to 57 (54.4±2.3) with the menopause lasting between 2 and 11 years (7.5±1.2) and with dyspareunia was carried out.Sexological examination included: interview method questionnaire; genitals vascular responses value (duplex Doppler scanning of clitoris vessels in XARIA TOSHIBA machine before and after video-erotic stimulation). Patients were given injections of autologous PRP (6 ml of plasma containing platelet concentration around 1.6 times the baseline where more than 80% are viable) in the region of paraurethral zone, introitus vagina and vagina twice with the interval of 21-22 days. Dyspareunia developed against the background of lubrication disturbance and was accompanied by the reduction of libido (88.5%), formation of secondary anorgasmia (40.4%) and disharmony in relations of partners (32.7%). Doppler scanning of clitoris vessels registered: maximum speed of blood flow (Vsmax) – 1.6–2.3 cm/sec at rest and 3.1–4.1 cm/sec in 30 minutes after video-erotic stimulation; resistance index (IR) – 0.79-0.81 at rest and 0.84-1.0 after the stimulation. Treatment of female sexual dysfunctions was based on the principles of interdisciplinary approach: both individual and couple psychotherapy and a course of PRP therapy (2 procedures). On the 7th day after the PRP therapy we established improvement of lubrication. After the treatment Vsmax of clitoris vessels amounted to 3.7-5.8 cm/sec at rest and 5.3-8.5 cm/sex after the stimulation, IR was 0.51-0.62 and 0.58-0.68 accordingly. As a result of the treatment we established gradual removal of dyspareunia symptoms in 73.1% and reduction of dyspareunia intensiveness in 26.9%. Use of PRP promotes improvement of blood flow in urogenitals, restoration of lubrication and removal of dyspareunia symptoms in postmenopausal women. No conflict of interest.