Palucci Mariachiara, Barba Marta, Cola Alice, Costa Clarissa, De Vicari Desirèe, Frigerio Matteo
Department of Gynecology, Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, 20900 Monza, Italy.
Clin Pract. 2025 Aug 20;15(8):155. doi: 10.3390/clinpract15080155.
: The decline of serum estrogen in postmenopausal women leads to several changes in the vulvovaginal and vesicourethral areas, resulting in the genitourinary syndrome of menopause (GSM), characterized by bothersome symptoms such as vaginal atrophy, lack of lubrication, dyspareunia, urgency, dysuria, and recurrent urinary tract infections. Nevertheless, this condition could also be experienced by younger women affected by hormone-dependent tumors. Although topical estrogens are considered "the gold standard", hormonal treatments cannot be indicated in cancer survivors. As a result, energy-based devices using radiofrequency and laser technologies have emerged as alternative options. This prospective study aimed to evaluate the benefits of non-invasive monopolar radiofrequency (RF) in women affected by GSM who have contraindications to, did not respond to, or declined local estrogen therapy. : The patients underwent five weekly sessions of second-generation monopolar RF. At baseline and at the fifth session, two validated questionnaires were administered to the patients: the Visual Analogue Scale (VAS) and the Female Sexual Function Index (FSFI-19). On the other hand, the vaginal mucosa status was evaluated by clinicians through the Vaginal Health Index (VHI). At the end of the cycle, the Patient Global Impression of Improvement (PGI-I) questionnaire was collected. : Based on 44 patients who completed five sessions of radiofrequency, a significant improvement was observed in sexual function according to the FSFI scale (22.9 vs. 38.6; < 0.001) and in VVA atrophy symptoms, as documented by the VAS score (223 vs. 125; < 0.001). The mean VHI score increased by 3 points ( < 0.001). Moreover, according to PGI-I, 96% of patients reported a perceived improvement (PGI-I score ≤ 3). : Radiofrequency could provide an innovative and safe therapeutic approach for patients suffering from GSM and VVA, especially when hormonal strategies are unsuitable.
绝经后女性血清雌激素水平下降会导致外阴阴道和膀胱尿道区域出现多种变化，从而引发绝经泌尿生殖综合征（GSM），其特征为令人烦恼的症状，如阴道萎缩、缺乏润滑、性交困难、尿急、尿痛和复发性尿路感染。然而，受激素依赖性肿瘤影响的年轻女性也可能出现这种情况。尽管局部雌激素被认为是“金标准”，但癌症幸存者不能使用激素治疗。因此，基于射频和激光技术的能量设备已成为替代选择。这项前瞻性研究旨在评估非侵入性单极射频（RF）对有GSM且对局部雌激素治疗有禁忌证、无反应或拒绝接受该治疗的女性的益处。
患者接受了为期五周的第二代单极射频治疗。在基线和第五次治疗时，向患者发放了两份经过验证的问卷：视觉模拟量表（VAS）和女性性功能指数（FSFI - 19）。另一方面，临床医生通过阴道健康指数（VHI）评估阴道黏膜状态。在治疗周期结束时，收集患者整体改善印象（PGI - I）问卷。
基于44名完成五次射频治疗的患者，根据FSFI量表，性功能有显著改善（22.9对38.6；<0.001），VAS评分记录显示阴道萎缩症状也有改善（223对125；<0.001）。VHI平均得分提高了3分（<0.001）。此外，根据PGI - I，96%的患者报告感觉有改善（PGI - I评分≤3）。
射频可为患有GSM和阴道萎缩的患者提供一种创新且安全的治疗方法，尤其是在激素治疗策略不合适的时候。
