A comparison between vaginal estrogen and vaginal hyaluronic for the treatment of dyspareunia in women using hormonal contraceptive
This randomized clinical study was published in 2015 in European Journal of Obstetrics & Gynecology and Reproductive biology (IF 2016:1.666) by Italian gynecologists. 31 Consecutive sexually active women (mean age of 31) using COC and complaining of de novo dyspareunia were enrolled in the study. Two attending physicians were involved in the study: the first, prescribed a 12-week vaginal estrogenic therapy with estriol 50 mg/g gel twice a week (group 1) and the second a hyaluronic acid vaginal gel therapy once a day (group 2). The dyspareunia levels with visual analogic scale (VAS) and sexual function with Female Sexual Function Index (FSFI) were evaluated. Vaginal atrophy was graded per the vaginal maturation index (VM). In our study we chose Gelistrol1 as oestrogen vaginal preparation because one dose of Gelistrol1 contains 0.05 mg (i.e. 50 mcg) of estriol, which is a much lower dose than that of other preparations (e.g. Ovestin1) containing 0.5 mg per dose.
Our data show that vaginal estriol 50 mg/g gel and vaginal hyaluronic acid could reduce dyspareunia caused by vagina atrophy in women using COC. These treatments in these women improve also the sexual function on the basis of FSFI. However, the estriol 50 mg/g gel appears to be significantly more effective in comparison with hyaluronic acid. BUT, it is reported that a prolonged intake of COC could cause or predispose to atrophic vulvovaginitis and reduce vaginal lubrication.