Eur J Obstet Gynecol Reprod Biol. 2015 Aug;191:48-50. doi: 10.1016/tejogrb.2015.05.026. Epub 2015 Jun 3.

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

Serati V’, Bogani G2, Di Dedda MC2, Braghlroll A2, Uccella S2, Cromi A2, Ghezzi F2. Abstract


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).


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 vaghal estrogenic therapy with estriol 50 pg/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 ( ‘V).


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 VV (73.80 (±8.78) vs. 64.50 (±12.75); p=0.003) values in comparison to the patients in group 2.


Our study showed that vaginal supplementation with estriol 50 pg/g gel or with hyaluronic acid could reduce the de novo dyspareunia related to COC. In this cluster of patients, both treatments improve sexuality.