摘要

Objectives: The aim of this observational pilot study is to assess the effect of low molecular weight hyaluronic acid combined with six specific amino acids in the form of sub- cutaneous and sub-mucosal injections on the clinical condition of the vulvo-vaginal tissues in women with vulvar and vaginal atrophy (VVA). Introduction: The menopause-related decline in estrogen levels leads to a range of genital, sexual, and urinary symptoms collectively known as genitourinary syndrome of menopause [1].The constellation of symptoms associated with vulvar and vaginal atrophy (VVA) can have a profoundly damaging effect on sexual function, relationships and the quality of life of a woman [2].The progressive hypotrophy of the dermis and mucosa due to lack of estrogenic stimulus on fibroblast activity determines a consequent loss of elasticity, increased laxity, fragility and sub-chronic inflammation. Materials / method: Perimenopausal women (47-54yo) were enrolled in the study, all with VVA-related symptoms. Every 21 days and three times they received an intradermal and intramucosal injection, at the vulvar and vaginal introital level, of low molecular weight Hyaluronic Acid between 50 and 200KD (LMWHA) added to six amino acids (6AA), in small boluses of about 0.03 ml each, for a total of 1.5 ml per session. Symptoms and signs of VVA were assessed through the completion of VAS and FSFI questionnaires and gynecological examination. Results: The results achieved have been evaluated in vitro in other study and clinically, in vivo, through the improvement of symptoms in this specific pilot and observational study. The results achieved by gynecological examination, VAS and FSFI questionnaires on the improvement of symptoms are encouraging although preliminary. Conclusion: The use of low molecular weight Hyaluronic Acid (LMWHA) added to six specific amino acids in proportion and quantity balanced to be injected into the vulvo-vaginal and introital areas, allows the construction of a new extra-cell matrix and the restoration of its structural, barrier and cellular metabolic exchange functions [3]. The neo-production of collagen types 4 and 7 as well as Elastin has been demonstrated through repeated injection in this area. This makes this procedure a very good support to prevent and care signs and symptoms VVA related.