Hyaluronic acid injection to treat symptoms of vulvovaginal atrophy and improve sexual function in postmenopausal women: A 52-week long-term follow-up.

Objectives: To evaluate the long-term efficacy and safety of a single injection session of cross-linked hyaluronic acid for postmenopausal vulvovaginal atrophy.

Study Design: 12-week, randomised, placebo-controlled, single-blind phase followed by 40-week open-label phase. At study start, patients received hyaluronic acid or placebo injection. At 12 weeks, patients who initially received placebo received hyaluronic acid.

Main Outcome Measures: Mean change from baseline in the severity score of the most bothersome symptom, scores for vulvovaginal atrophy individual symptoms, score on the Female Sexual Function Index and vaginal pH after hyaluronic acid injection. Patients receiving hyaluronic acid were followed to 36 weeks or 52 weeks if treated at study start.

Results: 115 patients receiving hyaluronic acid were analysed. The mean score for most bothersome symptom and all individual symptom scores were significantly reduced from baseline at all time points (p < 0.001). The initial decrease in most bothersome symptom was observed at 4 weeks, with a mean (SD) decrease of -1.05 (1.05) to 1.69 (1.11), and maintained up to 52 weeks. Mean full-scale score on the Female Sexual Function Index was significantly increased from baseline at all time points (p < 0.001). The initial increase was observed at 4 weeks, with a mean increase of 4.50 (6.51) to 20.54 (8.60), and maintained up to 52 weeks. Improvement was observed across all domains of the Female Sexual Function Index. There was a general trend for improvement in vaginal pH.

Conclusions: A single injection session of hyaluronic acid is effective in reducing vulvovaginal symptomatology and in improving sexual function for up to 52 weeks, making it a suitable management option for moderate to severe vulvovaginal atrophy symptoms.

Clinical Trials: gov identifier NCT04219722.