Objective: Vulvovaginal Atrophy / Genitourinary Syndrome of Menopause (VVA/GSM) is a clinical manifestation of symptoms at vaginal level, associated to menopause, as dryness, burning, and itching, or impairment of sexual life. Physicians have several options that can be adopted to improve patient health. The clinical use of Low Molecular Weight Hyaluronic Acid (LMWHA) represents one of the most interesting approach for these patients. The aim of this work is to evaluate the ability of LMWHA to improve VVA/GSM symptoms on menopausal women.

Patients and Methods: 50 menopausal women reporting dryness, itching, burning and dyspareunia, were enrolled. Vaginal and oral administrations of LMWHA were performed in association with radiofrequency (RF) and poration (PO) treatment sessions. For the first five weeks, one oral tablet with 100 mg of LMWHA was administered everyday while, at vaginal level, one suppository for day, containing 5 mg of LMWHA, 1 mg of Vitamin A and 1 mg of Vitamin E, was administered in the two days preceding RF. One RF/PO session for week was performed, during the first five weeks. When RF was interrupted, LMWHA treatment was continued with daily administrations of one suppository for two weeks and one tablet for ten months. At baseline (T0), and after 5 weeks (T1), 6 months (T2) and 12 months (T3) all patients have reported symptoms perception. Primary and secondary outcomes of this study were improvements of vaginal dryness and of all other symptoms respectively.

Results: A rapid improvement of vaginal dryness was reported when compared to T0, with reductions of 80.28%, 79.77% and 67.91% at T1, T2 and T3, respectively. In a similar way, also all other symptoms were resulted improved, and the result has remained stable over time.

Conclusions: Considering data obtained, LMWHA administration represents an innovative solution to improve symptomatology of VVA/GSM patients.