A comparison between vaginal estrogen and vaginal hyaluronic for the treatment of dyspareunia in women using hormonal contraceptive

Maurizio Serati, Giorgio Bogani, Maria Carmela Di Dedda, Alice Braghiroli, Stefano Uccella, Antonella Cromi, Fabio Ghezzi

Research output: Contribution to journalArticlepeer-review


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). Study design 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.

Original languageEnglish
Pages (from-to)48-50
Number of pages3
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Publication statusPublished - Aug 1 2015


  • Dyspareunia
  • Hormonal contraception
  • Hyaluronic acid
  • Oestrogen
  • Sexual function

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine


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