title: A comparison between vaginal estrogen and vaginal hyaluronic for the treatment of dyspareunia in women using hormonal contraceptive.
abstract: OBJECTIVE
  To evaluate the efficacy of topical vaginal estrogens in comparison to hyaluronic acid for the treatment of de novo dyspareunia in women using hormonal oral contraceptive (COC).
  
  
  METHODS
  Consecutive sexually active women 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 μg/g gel twice a week (group 1) and the second a hyaluronic acid vaginal gel therapy once a day (group 2). We evaluated dyspareunia levels using visual analogic scale (VAS) and sexual function using Female Sexual Function Index (FSFI). Vaginal atrophy was graded per the vaginal maturation index (VM).
  
  
  RESULTS
  Overall, 31 women were enrolled. Seventeen and 14 patients were allocated in group 1 and 2, respectively. In both groups, after the topical therapy, dyspareunia, sexual function and VM were significantly improved. However, patients in group 1 experienced a significantly lower score of dyspareunia than patients in the group 2 (2 (1-7) vs. 4 (2-7); p=0.02). Additionally, women in the group 1 had higher FSFI (29.20 (24.60-34.50) vs. 28.10 (23.60-36.50); p=0.04) scores and VM (73.80 (±8.78) vs. 64.50 (±12.75); p=0.003) values in comparison to the patients in group 2.
  
  
  CONCLUSIONS
  Our study showed that vaginal supplementation with estriol 50 μg/g gel or with hyaluronic acid could reduce the de novo dyspareunia related to COC. In this cluster of patients, both treatments improve sexuality. However, estriol 50 μg/g gel appears to be significantly more effective in comparison with hyaluronic acid.
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy. Electronic address: mauserati@hotmail.com.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Serati
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bogani
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Maria Carmela
authors.initials: MC
authors.lastname: Di Dedda
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Braghiroli
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Uccella
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Cromi
authors.affiliation: Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ghezzi
mesh_terms: D000328:Adult; D001284:Atrophy; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D004334:Drug Administration Schedule; D004414:Dyspareunia / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D004964:Estriol / Q000008:administration & dosage* / Q000627:therapeutic use; D004967:Estrogens / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005782:Gels; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage* / Q000627:therapeutic use; D007558:Italy; D054327:Lubricants / Q000008:administration & dosage* / Q000627:therapeutic use; D009092:Mucous Membrane / Q000187:drug effects / Q000473:pathology; D010147:Pain Measurement / Q000187:drug effects; D012725:Sexual Behavior / Q000187:drug effects; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D014621:Vagina / Q000187:drug effects / Q000473:pathology; D014622:Vaginal Creams, Foams, and Jellies; D055815:Young Adult
chemical_list: D003278:Contraceptives, Oral, Hormonal; D004967:Estrogens; D005782:Gels; D054327:Lubricants; D014622:Vaginal Creams, Foams, and Jellies; D006820:Hyaluronic Acid; D004964:Estriol
keywords: Dyspareunia; Hormonal contraception; Hyaluronic acid; Oestrogen; Sexual function