Возможности и перспективы локального применения гиалуроновой кислоты при вульвовагинальной атрофии у женщин репродуктивного возраста
Возможности и перспективы локального применения гиалуроновой кислоты при вульвовагинальной атрофии у женщин репродуктивного возраста
Прилепская В.Н., Назарова Н.М., Девяткина А.Р., Абакарова П.Р., Межевитинова Е.А. Возможности и перспективы локального применения гиалуроновой кислоты при вульвовагинальной атрофии у женщин репродуктивного возраста. Гинекология. 2024;26(3):254–259. DOI: 10.26442/20795696.2024.3.202932
Prilepskaya VN, Nazarova NM, Devyatkina AR, Abakarova PR, Mezhevitinova EA. Potential and perspectives of local application of hyaluronic acid in vulvovaginal atrophy in women of reproductive age: A review. Gynecology. 2024;26(3):254–259. DOI: 10.26442/20795696.2024.3.202932
Возможности и перспективы локального применения гиалуроновой кислоты при вульвовагинальной атрофии у женщин репродуктивного возраста
Прилепская В.Н., Назарова Н.М., Девяткина А.Р., Абакарова П.Р., Межевитинова Е.А. Возможности и перспективы локального применения гиалуроновой кислоты при вульвовагинальной атрофии у женщин репродуктивного возраста. Гинекология. 2024;26(3):254–259. DOI: 10.26442/20795696.2024.3.202932
Prilepskaya VN, Nazarova NM, Devyatkina AR, Abakarova PR, Mezhevitinova EA. Potential and perspectives of local application of hyaluronic acid in vulvovaginal atrophy in women of reproductive age: A review. Gynecology. 2024;26(3):254–259. DOI: 10.26442/20795696.2024.3.202932
Нарушение структуры и функции вульвовагинального эпителия у женщин репродуктивного возраста сопровождается снижением сексуальной функции и качества жизни. В представленном обзоре проведен анализ данных исследований по применению гиалуроновой кислоты (ГК) у женщин репродуктивного возраста с различными состояниями и заболеваниями, проявляющимися вульвовагинальной атрофией. ГК участвует в различных физиологических процессах в организме, регенерации тканей, миграции и пролиферации клеток при воспалении, помогает поддерживать водный баланс и целостность структуры тканей. Локальная терапия ГК эффективна в отношении всех симптомов вульвовагинальной атрофии у женщин репродуктивного возраста, связанных с гипоэстрогенией, как в форме монотерапии, так и при комбинированном лечении, способствуя улучшению сексуальной функции и повышению качества жизни.
Disruption of the structure and function of the vulvovaginal epithelium in women of reproductive age is accompanied by impaired sexual function and a decrease in the quality of life. This review analyses research on the use of hyaluronic acid (HA) for women of reproductive age with conditions and diseases manifesting as vulvovaginal atrophy. HA is involved in various physiological processes, including tissue regeneration, cell migration and proliferation during inflammation, and helps maintain water balance and tissue integrity. Local therapy with HA is effective in treating the symptoms of vulvovaginal atrophy in women of reproductive age associated with hypoestrogenism, both as a monotherapy and in combination with other treatments. It improves sexual function and quality of life, helping women to improve their sexual lives and living standards.
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2. Lev-Sagie A. Vulvar and vaginal atrophy: Physiology, clinical presentation, and treatment considerations. Clin Obs Gynecol. 2015;58(3):476-91. DOI:10.1097/GRF.0000000000000126
3. Mac Bride MB, Rhodes DJ, Shuster LT. Vulvovaginal atrophy. Mayo Clin Proc. 2010;85(1):87-94. DOI:10.4065/mcp.2009.0413
4. Alvisi S, Gava G, Orsili I, et al. Vaginal health in menopausal women. Medicina (Kaunas). 2019;55(10):615. DOI:10.3390/medicina55100615
5. Robinson D, Cardozo LD. The role of estrogens in female lower urinary tract dysfunction. Urology. 2003;62(4 Suppl. 1):45-51. DOI:10.1016/s0090-4295(03)00676-9
6. Escobar C, Rosenblum N. Vaginal estrogen – what a urologist should know. Urology. 2021;151:37-43. DOI:10.1016/j.urology.2020.05.034
7. Bayer IS. Hyaluronic acid and controlled release: A review. Molecules. 2020;25(11):2649. DOI:10.3390/molecules25112649
8. Toole BP. Hyaluronan: From extracellular glue to pericellular cue. Nat Rev Cancer. 2004;4(7):528-39. DOI:10.1038/nrc1391
9. Fallacara A, Baldini E, Manfredini S, Vertuani S. Hyaluronic acid in the third millennium. Polymers (Basel). 2018;10(7):701. DOI:10.3390/polym10070701
10. Leeman LM, Rogers RG. Sex after childbirth: Postpartum sexual function. Obstet Gynecol. 2012;119(3):647-55. DOI:10.1097/AOG.0b013e3182479611
11. Banaei M, Azizi M, Moridi A, et al. Sexual dysfunction and related factors in pregnancy and postpartum: A systematic review and meta-analysis protocol. Syst Rev. 2019;8(1):161. DOI:10.1186/s13643-019-1079-4
12. Rowland M, Foxcroft L, Hopman WM, Patel R. Breastfeeding and sexuality immediately postpartum. Can Fam Physician. 2005;51(10):1366-7. PMID:16926969
13. Agarwal SK, Kim J, Korst LM, Hughes CL. Application of the estrogen threshold hypothesis to the physiologic hypoestrogenemia of lactation. Breastfeed Med. 2015;10(2):77-83. DOI:10.1089/bfm.2014.0030
14. Gustavino C, Sala P, Cusini N, et al. Efficacy and safety of prolonged-release hyaluronic acid derivative vaginal application in the postpartum period: A prospective randomised clinical trial. Ann Med. 2021;53(1):1589-97. DOI:10.1080/07853890.2021.1974083
15. Менопауза и климактерическое состояние у женщины. Клинические рекомендации РОАГ. 2021. Режим доступа: https://cr.minzdrav.gov.ru/recomend/117_2. Ссылка активна на 16.05.2024 [Menopauza i klimaktericheskoe sostoianie u zhenshchiny. Klinicheskie rekomendatsii ROAG. 2021. Available at: https://cr.minzdrav.gov.ru/recomend/117_2. Accessed: 16.05.2024 (in Russian)].
16. Ekin M, Yaşar L, Savan K, et al. The comparison of hyaluronic acid vaginal tablets with estradiol vaginal tablets in the treatment of atrophic vaginitis: A randomized controlled trial. Arch Gynecol Obstet. 2011;283(3):539-43. DOI:10.1007/s00404-010-1382-8
17. Jokar A, Davari T, Asadi N, et al. Comparison of the hyaluronic acid vaginal cream and conjugated estrogen used in treatment of vaginal atrophy of menopause women: A randomized controlled clinical trial. Int J Community Based Nurs Midwifery. 2016;4(1):69-78. PMID:26793732
18. Cox P, Panay N. Vulvovaginal atrophy in women after cancer. Climacteric. 2019;22(6):565-71. DOI:10.1080/13697137.2019.1643180
19. Sabatini R, Cagiano R. Comparison profiles of cycle control, side effects and sexual satisfaction of three hormonal contraceptives. Contraception. 2006;74(3):220-3. DOI:10.1016/j.contraception.2006.03.022
20. Handy AB, McMahon LN, Goldstein I, Meston CM. Reduction in genital sexual arousal varies by type of oral contraceptive pill. J Sex Med. 2023;20(8):1094-102. doi:10.1093/jsxmed/qdad072
21. Cotangco K, Class QA, Johnson TP, Kothari R. Cervical cancer survivors' attitudes and understanding of menopause and hormone therapy. Menopause. 2020;27(6):701-5. DOI:10.1097/GME.0000000000001520
22. Dafni U, Tsourti Z, Alatsathianos I. Breast cancer statistics in the European Union: Incidence and survival across European Countries. Breast Care (Basel). 2019;14(6):344-53. DOI:10.1159/000503219
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24. Santen RJ, Stuenkel CA, Davis SR, et al. Managing menopausal symptoms and associated clinical issues in breast cancer survivors. J Clin Endocrinol Metab. 2017;102(10):3647-61. DOI:10.1210/jc.2017-01138
25. Kingsberg SA, Larkin L, Krychman M, et al. WISDOM survey: Attitudes and behaviors of physicians toward vulvar and vaginal atrophy (VVA) treatment in women including those with breast cancer history. Menopause. 2019;26(2):124-31. DOI:10.1097/GME.0000000000001194
26. The NAMS 2020 GSM Position Statement Editorial Panel. The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society. Menopause. 2020;27(9):976-92. DOI:10.1097/GME.0000000000001609
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30. Krapf JM, Mitchell L, Holton MA, Goldstein AT. Vulvar lichen sclerosus: Current perspectives. Int J Womens Health. 2020;12:11-20. DOI:10.2147/IJWH.S191200
31. Singh N, Ghatage P. Etiology, clinical features, and diagnosis of vulvar lichen sclerosus: A scoping review. Obstet Gynecol Int. 2020;2020:7480754. DOI:10.1155/2020/7480754
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33. Van der Meijden WI, Boffa MJ, Ter Harmsel B, et al. 2021 European guideline for the management of vulval conditions. J Eur Acad Dermatol Venereol. 2022;36(7):952-72. DOI:10.1111/jdv.18102
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35. Charman CR, Morris AD, Williams HC. Topical corticosteroid phobia in patients with atopic eczema. Br J Dermatol. 2000;142(5):931-6. DOI:10.1046 j.1365-2133.2000.03473.x
36. Aubert-Wastiaux H, Moret L, Le Rhun A, et al. Topical corticosteroid phobia in atopic dermatitis: A study of its nature, origins and frequency. Br J Dermatol. 2011;165(4):808-14. DOI:10.1111/j.1365-2133.2011.10449.x
37. Dreisler E, Kjer JJ. Asherman's syndrome: Current perspectives on diagnosis and management. Int J Womens Health. 2019;11:191-8. DOI:10.2147/IJWH.S165474
38. Lee WL, Liu CH, Cheng M, et al. Focus on the primary prevention of intrauterine adhesions: Current concept and vision. Int J Mol Sci. 2021;22(10):5175. DOI:10.3390/ijms22105175
39. Tafti SZG, Javaheri A, Firoozabadi RD, et al. Role of hyaluronic acid intrauterine injection in the prevention of Asherman's syndrome in women undergoing uterine septum resection: An RCT. Int J Reprod Biomed. 2021;19(4):339-46. DOI:10.18502/ijrm.v19i4.9060
40. Huang CY, Chang WH, Cheng M, et al. Crosslinked hyaluronic acid gels for the prevention of intrauterine adhesions after a hysteroscopic myomectomy in women with submucosal myomas: A prospective, randomized, controlled trial. Life (Basel). 2020;10(5):67. DOI:10.3390life10050067
41. Wang YQ, Song XH, Wu SL, et al. Comparison of autocross-linked hyaluronic acid gel and intrauterine device for preventing intrauterine adhesions in infertile patients: A randomized clinical trial. Gynecol Minim Invasive Ther. 2020;9(2):74-80. DOI:10.4103/GMIT.GMIT_103_19
________________________________________________
1. Portman DJ, Gass ML; Vulvovaginal Atrophy Terminology Consensus Conference Panel. Genitourinary syndrome of menopause: New terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and the North American Menopause Society. Menopause. 2014;21(10):1063-8. DOI:10.1097/GME.0000000000000329
2. Lev-Sagie A. Vulvar and vaginal atrophy: Physiology, clinical presentation, and treatment considerations. Clin Obs Gynecol. 2015;58(3):476-91. DOI:10.1097/GRF.0000000000000126
3. Mac Bride MB, Rhodes DJ, Shuster LT. Vulvovaginal atrophy. Mayo Clin Proc. 2010;85(1):87-94. DOI:10.4065/mcp.2009.0413
4. Alvisi S, Gava G, Orsili I, et al. Vaginal health in menopausal women. Medicina (Kaunas). 2019;55(10):615. DOI:10.3390/medicina55100615
5. Robinson D, Cardozo LD. The role of estrogens in female lower urinary tract dysfunction. Urology. 2003;62(4 Suppl. 1):45-51. DOI:10.1016/s0090-4295(03)00676-9
6. Escobar C, Rosenblum N. Vaginal estrogen – what a urologist should know. Urology. 2021;151:37-43. DOI:10.1016/j.urology.2020.05.034
7. Bayer IS. Hyaluronic acid and controlled release: A review. Molecules. 2020;25(11):2649. DOI:10.3390/molecules25112649
8. Toole BP. Hyaluronan: From extracellular glue to pericellular cue. Nat Rev Cancer. 2004;4(7):528-39. DOI:10.1038/nrc1391
9. Fallacara A, Baldini E, Manfredini S, Vertuani S. Hyaluronic acid in the third millennium. Polymers (Basel). 2018;10(7):701. DOI:10.3390/polym10070701
10. Leeman LM, Rogers RG. Sex after childbirth: Postpartum sexual function. Obstet Gynecol. 2012;119(3):647-55. DOI:10.1097/AOG.0b013e3182479611
11. Banaei M, Azizi M, Moridi A, et al. Sexual dysfunction and related factors in pregnancy and postpartum: A systematic review and meta-analysis protocol. Syst Rev. 2019;8(1):161. DOI:10.1186/s13643-019-1079-4
12. Rowland M, Foxcroft L, Hopman WM, Patel R. Breastfeeding and sexuality immediately postpartum. Can Fam Physician. 2005;51(10):1366-7. PMID:16926969
13. Agarwal SK, Kim J, Korst LM, Hughes CL. Application of the estrogen threshold hypothesis to the physiologic hypoestrogenemia of lactation. Breastfeed Med. 2015;10(2):77-83. DOI:10.1089/bfm.2014.0030
14. Gustavino C, Sala P, Cusini N, et al. Efficacy and safety of prolonged-release hyaluronic acid derivative vaginal application in the postpartum period: A prospective randomised clinical trial. Ann Med. 2021;53(1):1589-97. DOI:10.1080/07853890.2021.1974083
15. Menopauza i klimaktericheskoe sostoianie u zhenshchiny. Klinicheskie rekomendatsii ROAG. 2021. Available at: https://cr.minzdrav.gov.ru/recomend/117_2. Accessed: 16.05.2024 (in Russian).
16. Ekin M, Yaşar L, Savan K, et al. The comparison of hyaluronic acid vaginal tablets with estradiol vaginal tablets in the treatment of atrophic vaginitis: A randomized controlled trial. Arch Gynecol Obstet. 2011;283(3):539-43. DOI:10.1007/s00404-010-1382-8
17. Jokar A, Davari T, Asadi N, et al. Comparison of the hyaluronic acid vaginal cream and conjugated estrogen used in treatment of vaginal atrophy of menopause women: A randomized controlled clinical trial. Int J Community Based Nurs Midwifery. 2016;4(1):69-78. PMID:26793732
18. Cox P, Panay N. Vulvovaginal atrophy in women after cancer. Climacteric. 2019;22(6):565-71. DOI:10.1080/13697137.2019.1643180
19. Sabatini R, Cagiano R. Comparison profiles of cycle control, side effects and sexual satisfaction of three hormonal contraceptives. Contraception. 2006;74(3):220-3. DOI:10.1016/j.contraception.2006.03.022
20. Handy AB, McMahon LN, Goldstein I, Meston CM. Reduction in genital sexual arousal varies by type of oral contraceptive pill. J Sex Med. 2023;20(8):1094-102. doi:10.1093/jsxmed/qdad072
21. Cotangco K, Class QA, Johnson TP, Kothari R. Cervical cancer survivors' attitudes and understanding of menopause and hormone therapy. Menopause. 2020;27(6):701-5. DOI:10.1097/GME.0000000000001520
22. Dafni U, Tsourti Z, Alatsathianos I. Breast cancer statistics in the European Union: Incidence and survival across European Countries. Breast Care (Basel). 2019;14(6):344-53. DOI:10.1159/000503219
23. Lubián López DM. Management of genitourinary syndrome of menopause in breast cancer survivors: An update. World J Clin Oncol. 2022;13(2):71-100. DOI:10.5306/wjco.v13.i2.71
24. Santen RJ, Stuenkel CA, Davis SR, et al. Managing menopausal symptoms and associated clinical issues in breast cancer survivors. J Clin Endocrinol Metab. 2017;102(10):3647-61. DOI:10.1210/jc.2017-01138
25. Kingsberg SA, Larkin L, Krychman M, et al. WISDOM survey: Attitudes and behaviors of physicians toward vulvar and vaginal atrophy (VVA) treatment in women including those with breast cancer history. Menopause. 2019;26(2):124-31. DOI:10.1097/GME.0000000000001194
26. The NAMS 2020 GSM Position Statement Editorial Panel. The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society. Menopause. 2020;27(9):976-92. DOI:10.1097/GME.0000000000001609
27. Shah MB, Hoffstetter S. Contraception and sexuality. Minerva Ginecol. 2010;62(4):331-47. PMID:20827250
28. Casey PM, MacLaughlin KL, Faubion SS. Impact of contraception on female sexual function. J Womens Health (Larchmt). 2017;26(3):207-13. DOI:10.1089/jwh.2015.5703
29. Zhuravleva JA, Prokhorova OV, Gepting NA, et al. Female sexuality and combined oral contraceptive pills: Administration and correction issues. Russian Bulletin of Obstetrician-Gynecologist. 2020;20(6):101-6 (in Russian). DOI:10.17116/rosakush202020061101
30. Krapf JM, Mitchell L, Holton MA, Goldstein AT. Vulvar lichen sclerosus: Current perspectives. Int J Womens Health. 2020;12:11-20. DOI:10.2147/IJWH.S191200
31. Singh N, Ghatage P. Etiology, clinical features, and diagnosis of vulvar lichen sclerosus: A scoping review. Obstet Gynecol Int. 2020;2020:7480754. DOI:10.1155/2020/7480754
32. Shperling NV, Shperling MI. Treatment and prevention of recurrent genital lichen sclerosus in women. Obstetrics and Gynecology. 2022;12:70-8 (in Russian). DOI:10.18565/aig.2022.280
33. Van der Meijden WI, Boffa MJ, Ter Harmsel B, et al. 2021 European guideline for the management of vulval conditions. J Eur Acad Dermatol Venereol. 2022;36(7):952-72. DOI:10.1111/jdv.18102
34. Lishai krasnyi ploskii. Klinicheskie rekomendatsii. 2020. Available at: https://cnikvi.ru/docs/klinicheskie-rekomendacii/КР%20КПЛ%202020.docx. Accessed: 16.05.2024 (in Russian).
35. Charman CR, Morris AD, Williams HC. Topical corticosteroid phobia in patients with atopic eczema. Br J Dermatol. 2000;142(5):931-6. DOI:10.1046 j.1365-2133.2000.03473.x
36. Aubert-Wastiaux H, Moret L, Le Rhun A, et al. Topical corticosteroid phobia in atopic dermatitis: A study of its nature, origins and frequency. Br J Dermatol. 2011;165(4):808-14. DOI:10.1111/j.1365-2133.2011.10449.x
37. Dreisler E, Kjer JJ. Asherman's syndrome: Current perspectives on diagnosis and management. Int J Womens Health. 2019;11:191-8. DOI:10.2147/IJWH.S165474
38. Lee WL, Liu CH, Cheng M, et al. Focus on the primary prevention of intrauterine adhesions: Current concept and vision. Int J Mol Sci. 2021;22(10):5175. DOI:10.3390/ijms22105175
39. Tafti SZG, Javaheri A, Firoozabadi RD, et al. Role of hyaluronic acid intrauterine injection in the prevention of Asherman's syndrome in women undergoing uterine septum resection: An RCT. Int J Reprod Biomed. 2021;19(4):339-46. DOI:10.18502/ijrm.v19i4.9060
40. Huang CY, Chang WH, Cheng M, et al. Crosslinked hyaluronic acid gels for the prevention of intrauterine adhesions after a hysteroscopic myomectomy in women with submucosal myomas: A prospective, randomized, controlled trial. Life (Basel). 2020;10(5):67. DOI:10.3390life10050067
41. Wang YQ, Song XH, Wu SL, et al. Comparison of autocross-linked hyaluronic acid gel and intrauterine device for preventing intrauterine adhesions in infertile patients: A randomized clinical trial. Gynecol Minim Invasive Ther. 2020;9(2):74-80. DOI:10.4103/GMIT.GMIT_103_19
ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И. Кулакова» Минздрава России, Москва, Россия
*n_nazarova@oparina4.ru
________________________________________________
Vera N. Prilepskaya, Niso M. Nazarova*, Anastasia R. Devyatkina, Patimat R. Abakarova, Elena A. Mezhevitinova
Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia
*n_nazarova@oparina4.ru