atrophy Archivi

The vagina: therapeutic role of prasterone

Linda Vignozzi^1,2– , Irene Scavello¹ – , Elisa Maseroli¹ – , Vincenzo Di Stasi¹– , Sarah Cipriani^1,2 –

1 – Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence

2 – SODc Andrology, Female Endocrinology and Gender Incongruence, Careggi University Hospital, Florence

Corresponding author: Linda Vignozzi

linda.vignozzi@unifi.it

DOI: 10.53146/lriog1202123

Abstract

Genitourinary menopause syndrome (GSM) is a chronic, progressive condition, which results from the effects of estrogenic and androgenic deficiency typical of menopausal age. It involves the genitourinary district and occurs with an extremely wide range of signs and symptoms. Dyspareunia, both superficial and deep, is among the main and most distressing symptoms of the GSM. Over the decades, different therapeutic approaches have been developed, aimed at improving the symptomatology and thus the quality of life of women, such as local estrogenic therapy, which until now has been considered the gold standard of GSM treatment. A new Prasterone formulation has recently been approved, which is biochemically and biologically identical to that of the endogenous human DHEA, an inactive steroid precursor that can be converted into estrogen and androgen into vaginal cells. The rationale of the use of prasterone is the theory of intracrinology, which is the proven ability of vaginal cells to convert an inactive compound into an active form. This molecule, absorbed locally, determines only a minimum increase in circulating hormonal values, which remains be- low the threshold of physiologic levels for menopausal women.

Keywords: prasterone; genitourinary syndrome; menopause; atrophy.

Available in LRIOG Nr.2 – 2021

e-ISSN: 1824-0283

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Genital filler – the 5Ws – What, Who, Where, When, Why?

Elena Fasola –

Gyplast Medical Institute, Milan

fasolaelena@yahoo.it

DOI: 10.53146/lriog1202110

Abstract

The recent introduction of injectable products in the market, hyaluronic acid based, indicated to counteract the signs and symptoms of tissue atrophy in vulvar area, inevitably generates the need to deepen the subject. The focus will be placed on the biochemical peculiarities and the ractional use of these products, to clarify how they are “processed” before being put on the market and therefore of what is infiltrated into the tissues at the end of the production process; what is the precise anatomical site in which they can be used, for what indications, with what techniques, contraindications and side effects. Among the products based on hyaluronic acid, first it is important to dwell on the big difference between non- cross-linked and cross-linked gels hyaluronic acid based, having themselves two different indications. The firsts are indicated for cutaneous and mucosal atrophy with eutrophication and biostimolating purposes, the seconds are used for iatrogenic scarring results, for example post-episioraffia or for reconstructive purposes in hypo / dystrophies of the fatty body of the Labia Majore and in macroscopic iatrogenic scarring with tissue loss. Also the technique by which they are injected is different (with needle or blunt tip cannula), with different contraindications and side effects. With a practical slant, the author intends to develop the topic with the aim of providing valid help to the doctor in his practical clinic.