Impact of microablative fractional radiofrequency on the vaginal health, microbiota, and cellularity of postmenopausal women

Abstract

We aimed to evaluate the effectiveness of microablative fractional radiofrequency (MAFRF) in the non-hormonal treatment of genitourinary syndrome of menopause. METHODS: We examined the cases of 55 postmenopausal women before and after treatment with regard to their vaginal health index (VHI), vaginal microbiota, vaginal pH, and cell maturation. Three applications of MAFRF were performed in the vagina/vaginal introitus. During the treatment, six vaginal smears were obtained and stained with the Papanicolaou stain for determining the degree of cell maturation and with Gram stain for classification of vaginal flora, as per the criteria of Spiegel and Amsel. For vaginal pH determination, pH indicator strips were applied against the vaginal wall. Statistical analysis was performed using SPSS for Windows (version 17.0). Data were reported as mean±standard deviation. The differences were analyzed using the statistical method of generalized estimation equations with autoregressive correlation structure ''1'' and robust standard errors. RESULTS: The mean age was 59.8±4.2 years, and the mean time of menopause was 15.4±4.5 years. After treatment, there was an increase in the percentage of Lactobacillus spp. (po0.001). Consequently, there was a progressive decrease in vaginal pH during the treatment (po0.001). Regarding cell maturation, there was a decrease in the percentage of parabasal cells (p=0.001) and an increase in the rate of superficial cells (po0.001). Additionally, there was an improvement in the VHI index. The mean VHI values before and after treatment were 13.2 ± 5.6 and 22.5 ± 3.7, respectively (po0.001). CONCLUSION: MAFRF treatment is well tolerated and leads to improvement in the vaginal microenvironment.

The Role of Gut, Vaginal, and Urinary Microbiome in Urinary Tract Infections: From Bench to Bedside

“…However, a hormonal treatment is not the only option; a recent study by Sarmento et al showed a statistically significant increase in the percentage of Lactobacillus spp. and a progressive decrease in vaginal pH when microablative fractional radiofrequency was used for the treatment of genitourinary syndrome of menopause [ 93 ]. Finally, vaginal microbiome transplantation from healthy donors to women suffering from intractable and recurrent bacterial vaginosis can be used to reconstitute vaginal flora towards a Lactobacillus -dominated vaginal microbiome [ 94 , 95 ], with potential consequences for UTI incidence.…”

Microablative fractional radiofrequency for the genitourinary syndrome of menopause: protocol of randomised controlled trial

“…Therefore, with an equal 1:1:1 allocation rate, according to the results of a pilot study, where data came from 55 volunteers, 28 accepting an alpha of 0.05 and a beta risk…”

Microablative fractional radiofrequency as a therapeutic option for vulvar lichen sclerosus: a pilot study

“…The first pilot study on vaginal and vestibular MFR for genitourinary menopausal syndrome reported that the intervention was effective on atrophy symptoms, was well tolerated, and was associated with a rapid recovery; however, the study included only a few women (21). More robust studies have confirmed that MFR can be beneficial in the treatment of patients with genitourinary disorders (22,23). Sarmento et al (22) conducted a randomized trial on the effects of MFR on vaginal health, microbiota, and cellularity in postmenopausal women.…”

“…More robust studies have confirmed that MFR can be beneficial in the treatment of patients with genitourinary disorders (22,23). Sarmento et al (22) conducted a randomized trial on the effects of MFR on vaginal health, microbiota, and cellularity in postmenopausal women. The preliminary results indicated that MFR considerably improved the vaginal microenvironment, similar to that expected in women with adequate estrogen concentrations.…”

“…Laser and fractioned radiofrequency are used to improve general skin and mucosal trophism, especially in the vagina and vulvar vestibule. Several researchers have reported that these interventions produce clinical improvement, as well as promising results in neocollagenesis and neoelastinogenesis assessed using histopathology, electron microscopy, and immunohistochemistry (8,(18)(19)(20)(21)(22)(23)(24). According to Condi et al (25), dermal collagen can be assessed by measuring collagen I and II fractions, and neocollagenesis can be evaluated using picrosirius staining with polarized microscopy to highlight fiber width and orientation.…”