Polycarbophil vaginal moisturizing gel versus hyaluronic acid gel in women affected by vaginal dryness in late menopausal transition: A prospective randomized trial

• Published in: European journal of obstetrics & gynecology and reproductive biology Vol. 270; pp. 239 - 245
• Main Authors: Cagnacci, Angelo, Barattini, Dionisio Franco, Casolati, Elena, Pecoroni, Alberto, Mangrella, Mario, Patrascu, Liviu Cristian
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01-03-2022
• Subjects: Acrylic Resins; Atrophy - chemically induced; Atrophy - drug therapy; Atrophy - pathology; Female; Humans; Hyaluronic acid; Hyaluronic Acid - therapeutic use; Late menopausal transition; Menopause; Middle Aged; Polycarbophil; Postmenopause; Prospective Studies; Sexuality; Treatment Outcome; Vagina - pathology; Vaginal Creams, Foams, and Jellies - therapeutic use; Vaginal Diseases - drug therapy; Vaginal Diseases - pathology; Vaginal dryness; Vulva - pathology; Late menopausal transition; Vaginal dryness; Hyaluronic acid; Polycarbophil; Sexuality
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2022.01.021

•This study demonstrates that the administration of PCV gel, for 30 days, significantly alleviates the symptoms of vaginal atrophy and dryness in women in late menopausal transition.•For all the parameters assessed, the performance of PCV was not inferior to that of HA.•These findings are of practical relevance giving gynecologists the opportunity to choose among evidence-based therapeutic tool for women in the late menopausal transition suffering from vaginal dryness.
During menopausal transition, women are frequently affected by vulvovaginal atrophy (VVA), due to the decline of estrogen levels. Resulting symptoms are itching, burning, dyspareunia, and vaginal dryness (reported in up to 85%). The aim of this trial was to verify if medical device polycarbophil vaginal (PCV) moisturizer gel is not less effective than hyaluronic acid (HA) gel in treating vaginal dryness.
This was a multicenter, open label, randomized, parallel group, comparative study with non-inferiority design. Female included were ≥45 to ≤55 years in the menopausal transition, with subjective dryness, any objective sign of VVA, pH > 5, and body mass index of ≥18.5 to ≤36 kg/m2. Subjects were randomized to 1 g of PCV gel twice a week for 30 days or 3 g of HA vaginal gel every 3 days for 30 days.
53 subjects (mean age 49.45 ± 2.96 years) were analyzed. Vaginal health index showed an improvement (p < 0.001) in both groups (from 12.54 ± 1.37 to 16.36 ± 2.66 for PCV, from 12.00 ± 1.91 to 16.60 ± 2.50 for HA), but the difference between final means (95%CI: −1.66 to 1.18) evidenced that PCV is non-inferior to HA treatment. Similarly, an improvement was evidenced in vaginal maturation index (p = 0.005 for PCV, ns. for HA), female sexual function index (p < 0.001 for PCV, p < 0.001 for HA), and SF-12 (p < 0.001 for PCV, p < 0.001 for HA), with no difference between groups. Safety was optimal and no adverse events were reported.
The use of HA gel does not give additional benefits to those that are already provided by the moisturizing PCV.