IMPACT OF MICROABLATIVE FRACTIONAL RADIOFREQUENCY ON VAGINAL HEALTH, MICROBIOTA, CELLULARITY AND SEXUAL FUNCTION IN WOMEN WITH THE MENOPAUSAL GENITOURINARY SYNDROME.
menopause; atrophy, radiofrequency therapy; laser therapy.
Objectives: This study aims to evaluate the impact of Microablative Fractional Radiofrequency (MAFRF) on postmenopausal women with vaginal atrophy. Methods: This was a randomized, controlled clinical trial of postmenopausal women diagnosed with urogenital atrophy. Treatment consisted of three sessions of MAFRF, compared to vaginal estrogen administration and an untreated control group. Assessments occurred at baseline and 30 days after the last session. The primary endpoints were sexual function, evaluated by the Female Sexual Function Index (FSFI), and vaginal health, assessed by the Vaginal Health Index (VHI). Secondary outcomes included Nugent score and Vaginal Maturation Index (VMI). Results: One hundred and twenty patients (40 in each group) were eligible for inclusion. Concerning the FSFI, both treatment groups (median [interquartile range], MAFRF (4.8 [2.4]) and vaginal estrogen (4.8 [2.3]), experienced improved sexual desire when compared to the control group (3.6 [2.4]), (p=0.020 and p=0.014), respectively. Regarding the total score of VHI, we observed an increase in the mean and standard deviation of the MAFRF (25.0 [2.0]) and vaginal estrogen groups (25.0 [3.0]) when compared to the control (15.0 [5.8]), (p < 0.01), for both groups. There was a decrease in the mean of the Nugent score in MAFRF (0.00) and vaginal estrogen groups (0.00), (p < 0.01), for both groups. Lastly, for the VMI, there were significant differences in the mean score of MAFRF (52.25) and vaginal estrogen (53.00) when compared to the control group (48.00), (p < 0.01 and p < 0.001), respectively. No significant differences were observed between the MAFRF and vaginal estrogen groups in any studied variables. Conclusions: Despite promising results found in this trial about the use of MAFRF in vaginal atrophy treatment, it is important to point out that larger and longer series regarding long-term safety are lacking.