Managing Vulvovaginal Atrophy, in Postmenopausal Women, Without Hormones: Efficacy of a Hyaluronic Acid Vaginal Moisturizer.

Background

Genitourinary syndrome is a common, chronic condition associated with estrogen deficiency that negatively impacts vaginal health, sexual function, and quality of life in peri- and postmenopausal women. Non-hormonal vaginal moisturizers represent an important therapeutic option for women who cannot or do not wish to use estrogen therapy.

Objective

The aim of this study was to evaluate the safety and efficacy of Provagin®, a hyaluronic acid-based non-hormonal vaginal moisturizer, in postmenopausal women with mild to moderate vaginal dryness.

Methods

This was a prospective, single-center, open-label, before-and-after clinical study with sexually active postmenopausal women. Participants applied 3 g of Provagin® intravaginally every three days for 22 ± 2 days. Clinical assessments were conducted at baseline, 24 and 72 h after first application, and after 6 and 22 days of use. Outcomes included vaginal pH, vaginal microbiota, epithelial integrity, participant-reported symptoms (vaginal dryness, dyspareunia, and pruritus), and adverse events.

Results

A total of 45 participants completed the study. Vaginal pH remained stable throughout the study period. No clinically relevant changes were observed in vaginal microbiota, except for a significant increase in Lactobacillus spp. counts. Epithelial integrity was preserved at all time points. Significant improvements in participant-reported symptoms were observed as early as 24 h after first use and continued through the study, with mean vaginal dryness scores decreasing by 69.3%.

Conclusions

Provagin® demonstrated a safety profile and was associated with improvements of genitourinary syndrome of menopause (GSM), without affecting vaginal pH, microbiota composition, or vaginal epithelial integrity. These findings support the use of Provagin® as a safe, non-hormonal therapeutic option for postmenopausal women with GSM.