IJCM  Vol.5 No.11 , May 2014
Oral Low-Molecular Weight Hyaluronic Acid in the Treatment of Atrophic Vaginitis
ABSTRACT


The aim of this study was to evaluate the effectiveness of low molecular weight hyaluronic acid oral tablets for the treatment of atrophic vaginitis. 12 women with atrophic vaginitis were recruited for this double blind, placebo-controlled study. Patients were randomized to receive either low molecular weight hyaluronic acid (HA) oral tablets or placebo for three months. Vaginal biopsies were taken at baseline and after three months of treatment, and vaginal epithelium was analysed using light microscopy. The evaluation of symptoms was self-assessed by the patients. Biopsies from HA group showed an epithelium thicker than in placebo group. The lamina propria from the HA group also showed a denser appearance compared to placebo group. Morphometric analysis showed significant differences between HA and baseline in the number of epithelial layers and in the thickness. The evaluation of symptoms also showed an effective improvement in the patients treated with HA, compared to baseline and to placebo group. In conclusion, oral administration of HA tablets improved the vaginal epithelium, decreasing atrophy. This can be an ideal option for patients with atrophic vaginitis who do not want to or can not take estrogen and show low compliance toward vaginal administration.


Cite this paper
Galia, T. , Micali, A. , Puzzolo, D. and Cancellieri, F. (2014) Oral Low-Molecular Weight Hyaluronic Acid in the Treatment of Atrophic Vaginitis. International Journal of Clinical Medicine, 5, 617-624. doi: 10.4236/ijcm.2014.511084.
References
[1]   Hayes, R. and Dennerstein, L. (2005) The Impact of Aging on Sexual Function and Sexual Dysfunction in Women: A Review of Population-Based Studies. Journal of Sexual Medicine, 2, 317-330.
http://dx.doi.org/10.1111/j.1743-6109.2005.20356.x

[2]   Koster, A. and Garde, K. (1993) Sexual Desire and Menopausal Development. A Prospective Study of Danish Women Born in 1936. Maturitas, 16, 49-60.
http://dx.doi.org/10.1016/0378-5122(93)90133-3

[3]   Dennerstein, L., Randolph, J., Taffe, J., et al. (2002) Hormones, Mood, Sexuality, and the Menopausal Transition. Fertility and Sterility, 77, S42-S48.
http://dx.doi.org/10.1016/S0015-0282(02)03001-7

[4]   Freedman, M.A. (2002) Quality of Life and Menopause: The Role of Estrogen. Journal of Women’s Health (Larchmt), 11, 703-718.
http://dx.doi.org/10.1089/15409990260363661

[5]   Johnston, S.L., Farrell, S.A., Bouchard, C., et al. (2004) The Detection and Management of Vaginal Atrophy. Journal of Obstetrics and Gynaecology Canada, 26, 503-515.

[6]   Woods, N.F. (2012) An Overview of Chronic Vaginal Atrophy and Options for Symptom Management. Nursing for Women’s Health, 16, 482-494.
http://dx.doi.org/10.1111/j.1751-486X.2012.01776.x

[7]   Palacios, S. (2009) Managing Urogenital Atrophy. Maturitas, 63, 315-318.
http://dx.doi.org/10.1016/j.maturitas.2009.04.009

[8]   Anderson, G.L., Chlebowski, R.T., Rossouw, J.E., et al. (2006) Prior Hormone Therapy and Breast Cancer Risk in the Women’s Health Initiative Randomized Trial of Estrogen plus Progestin. Maturitas, 55, 103-115.
http://dx.doi.org/10.1016/j.maturitas.2006.05.004

[9]   Chlebowski, R.T., Kuller, L.H., Prentice, R.L., et al. (2009) Breast Cancer after Use of Estrogen plus Progestin in Postmenopausal Women. New England Journal of Medicine, 360, 573-587.
http://dx.doi.org/10.1056/NEJMoa0807684

[10]   Rossouw, J.E., Anderson, G.L., Prentice, R.L., et al. (2002) Risks and Benefits of Estrogen plus Progestin in Healthy Postmenopausal Women: Principal Results from the Women’s Health Initiative Randomized Controlled Trial. JAMA, 288, 321-333.
http://dx.doi.org/10.1001/jama.288.3.321

[11]   Santen, R.J., Allred, D.C., Ardoin, S.P., et al. (2010) Postmenopausal Hormone Therapy: An Endocrine Society Scientific Statement. The Journal of Clinical Endocrinology & Metabolism, 95, s1-s66.
http://dx.doi.org/10.1210/jc.2009-2509

[12]   Beral, V., Reeves, G., Bull, D. and Green, J. (2011) Breast Cancer Risk in Relation to the Interval between Menopause and Starting Hormone Therapy. Journal of the National Cancer Institute, 103, 296-305.
http://dx.doi.org/10.1093/jnci/djq527

[13]   Morali, G., Polatti, F., Metelitsa, E.N., et al. (2006) Open, Non-Controlled Clinical Studies to Assess the Efficacy and Safety of a Medical Device in Form of Gel Topically and Intravaginally Used in Postmenopausal Women with Genital Atrophy. Arzneimittel-Forschung, 56, 230-238.

[14]   Panjari, M. and Davis, S.R. (2011) Vaginal DHEA to Treat Menopause Related Atrophy: A Review of the Evidence. Maturitas, 70, 22-25.
http://dx.doi.org/10.1016/j.maturitas.2011.06.005

[15]   Jenkins, M.R. and Sikon, A.L. (2008) Update on Nonhormonal Approaches to Menopausal Management. Cleveland Clinic Journal of Medicine, 75, S17-S24.
http://dx.doi.org/10.3949/ccjm.75.Suppl_4.S17

[16]   Ekin, M., Yasar, L., Savan, K., et al. (2011) The Comparison of Hyaluronic Acid Vaginal Tablets with Estradiol Vaginal Tablets in the Treatment of Atrophic Vaginitis: A Randomized Controlled Trial. Archives of Gynecology and Obstetrics, 283, 539-543.
http://dx.doi.org/10.1007/s00404-010-1382-8

[17]   Minozzi, M., Costantino, D. and Guaraldi, C. (2010) Acido Ialuronico per via Orale nel Trattamento della Distrofia Vaginale Nelle Pazienti in Postmenopausa. SIFIOG.

[18]   Holstein, A.F., Wartenberg, H. and Wulfhekel, U. (1971) Cytomorphological Studies on Spermatogenesis in Man. Verhandlungen der Anatomischen Gesellschaft, 65, 91-93.

[19]   Sturdee, D.W. and Panay, N. (2010) Recommendations for the Management of Postmenopausal Vaginal Atrophy. Climacteric, 13, 509-522.
http://dx.doi.org/10.3109/13697137.2010.522875

[20]   Tea, M.K.M., Priemer, V. and Kubista, E. (2006) Aktuelles: Wirksamkeit und Sicherheit von Hyaluron-Säure-Zäpfchen (Cikatridina(R)) bei der Behandlung Hormon-Oder Chemotherapieinduzierter Vaginaler Atrophie bei Ammakarzinompatientinnen. Journal für Fertilität und Reproduktion, Ausgabe für Österreich, 16, 17-19.

[21]   Ibrahim, S., Kang, Q.K. and Ramamurthi, A. (2010) The Impact of Hyaluronic Acid Oligomer Content on Physical, Mechanical, and Biologic Properties of Divinyl Sulfone-Crosslinked Hyaluronic Acid Hydrogels. Journal of Biomedical Materials Research Part A, 94, 355-370.

[22]   Lord, M.S., Pasqui, D., Barbucci, R. and Milthorpe, B.K. (2009) Protein Adsorption on Derivatives of Hyaluronic Acid and Subsequent Cellular Response. Journal of Biomedical Materials Research Part A, 91, 635-646.
http://dx.doi.org/10.1002/jbm.a.32219

 
 
Top