Laboratory of Biomedicine Translational, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Criciuma, SC, Brazil.
Laboratory of Evidence-Based Practice, Universidade Estadual de Mato Grosso do Sul, Campo Grande, MS, Brazil.
J Sex Med. 2021 Jan;18(1):156-166. doi: 10.1016/j.jsxm.2020.10.016. Epub 2020 Dec 5.
The decline in postmenopausal serum estrogen concentration results in several changes in the vulvovaginal and vesicourethral areas, resulting in the genitourinary syndrome of menopause, including symptoms such as vaginal atrophy.
To evaluate the effects of hyaluronic acid in vaginal atrophy.
A search strategy was developed using the following terms: "Hyaluronic Acid vaginal gel," "vaginal estrogens," "Vaginitis, Atrophic," and "Postmenopause." This strategy was used in major databases such as MEDLINE, EMBASE, Scopus, Cochrane library, Web of Science, Virtual Health Library (BVS), Congress Abstracts, and Gray Literature (Google Scholar and British Library) for studies published until June 2020.
A systematic review was carried out to assess the results of atrophic vaginitis/vaginal dryness, dyspareunia, vaginal pH, and cell maturation of the studies found by the search strategy.
A total of 833 studies were identified, 528 studies were directed for reading titles and abstracts, and 515 were excluded for not meeting the selection criteria. A total of 13 studies were selected for reading the full text. 5 primary studies involving 335 women met the criteria and were included. The studies were published between the years 2011 and 2017. It was not possible to perform meta-analysis owing to the substantial heterogeneity present in the studies. The results presented suggest that treatment with hyaluronic acid, when compared with the use of estrogens, does not present a significant difference in the results obtained for the outcomes: epithelial atrophy, vaginal pH, dyspareunia, and cell maturation.
Hyaluronic acid appears to be an alternative to non-hormonal treatments for the signs of vaginal atrophy and dyspareunia.
STRENGTHS & LIMITATIONS: The analysis of the studies in this systemic review suggests that hyaluronic acid has efficacy similar to vaginal estrogens for the treatment of the signs of vaginal atrophy and dyspareunia. However, the included studies measured the data in different ways, causing the performance of meta-analysis to be impaired.
The comparisons presented suggest that hyaluronic acid has a profile of efficacy, safety, and tolerability comparable with vaginal estrogens for the treatment of symptoms of vaginal atrophy. It is a possible alternative for women who cannot use hormonal treatment. dos Santos CCM, Uggioni MLR, Colonetti T, et al. Hyaluronic Acid in Postmenopause Vaginal Atrophy: A Systematic Review. J Sex Med 2021;18:156-166.
绝经后血清雌激素浓度下降导致外阴和尿道区域发生多种变化，导致女性生殖泌尿系统综合征，包括阴道萎缩等症状。
评估透明质酸对阴道萎缩的影响。
使用以下术语制定搜索策略：“透明质酸阴道凝胶”、“阴道雌激素”、“阴道萎缩性阴道炎”和“绝经后”。该策略在主要数据库（MEDLINE、EMBASE、Scopus、Cochrane 图书馆、Web of Science、虚拟健康图书馆（BVS）、大会摘要和灰色文献（Google Scholar 和大英图书馆））中使用，以检索截至 2020 年 6 月发表的研究。
进行了系统评价，以评估搜索策略发现的研究中阴道萎缩/阴道干燥、性交困难、阴道 pH 值和细胞成熟度的结果。
透明质酸在治疗绝经后阴道萎缩方面似乎是一种非激素治疗的替代方法。
纳入的研究以不同的方式测量数据，这使得荟萃分析的执行受到影响。
呈现的比较表明，透明质酸在治疗阴道萎缩症状方面具有与阴道雌激素相当的疗效、安全性和耐受性。对于不能使用激素治疗的女性来说，它可能是一种替代选择。
