Does Vaginal Estriol or Hyaluronic Acid Facilitate Office Hysteroscopy in Peri and Postmenopause? A Prospective Cohort Study

Background: Pain accompanying office hysteroscopy, possibly aggravated by urogenital atrophy, is the most common reason for its discontinuation. The aim was to evaluate the effectiveness of vaginal estriol and hyaluronic acid to facilitate the office hysteroscopy in peri and postmenopausal women. Me...

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Main Authors: Iwona Gawron, Rafał Baran, Kamil Derbisz, Andrzej Zmaczyński, Robert Jach, Miłosz Pietrus
Format: Article
Language:English
Published: IMR Press 2023-09-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009194
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author Iwona Gawron
Rafał Baran
Kamil Derbisz
Andrzej Zmaczyński
Robert Jach
Miłosz Pietrus
author_facet Iwona Gawron
Rafał Baran
Kamil Derbisz
Andrzej Zmaczyński
Robert Jach
Miłosz Pietrus
author_sort Iwona Gawron
collection DOAJ
description Background: Pain accompanying office hysteroscopy, possibly aggravated by urogenital atrophy, is the most common reason for its discontinuation. The aim was to evaluate the effectiveness of vaginal estriol and hyaluronic acid to facilitate the office hysteroscopy in peri and postmenopausal women. Methods: A prospective cohort study involved women aged 45–90 years subjected to office hysteroscopy. Women were assigned to three study arms: (A) 0.5 mg of estriol in vaginal cream twice daily for 10 days pre-procedure, (B) 5 mg of hyaluronic acid in vaginal gel twice daily for 10 days pre-procedure, (C) no medication. The following endpoints were compared: pain accompanying the procedure, need for cervical dilation, time of cervical passage, incidence of severe urogenital atrophy, and vaso-vagal reaction. Results: There were no significant differences between the arms in terms of pain intensity during (p = 0.93) and after the procedure (p = 0.17), need for cervical dilation (p = 0.5), cervical passage time (p = 0.1), severe urogenital atrophy (p = 0.15), and vaso-vagal reaction (p = 0.29). Conclusions: Despite unfavorable conditions in peri and postmenopausal women, cervical preparation in the above regimens did not seem to bring clinically significant benefits. Clinical Trial Registration: The study was registered under the number NCT05783479 in the Protocol Registration and Results System database (https://clinicaltrials.gov/). The database used for the study was made available in Harvard Dataverse (https://doi.org/10.7910/DVN/HSWURD).
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spelling doaj-art-e033a1b984a34fb4a7eae36fe3a809df2025-08-20T03:06:06ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-09-0150919410.31083/j.ceog5009194S0390-6663(23)02156-5Does Vaginal Estriol or Hyaluronic Acid Facilitate Office Hysteroscopy in Peri and Postmenopause? A Prospective Cohort StudyIwona Gawron0Rafał Baran1Kamil Derbisz2Andrzej Zmaczyński3Robert Jach4Miłosz Pietrus5Department of Gynecology and Obstetrics, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Krakow, PolandClinical Department of Gynecological Endocrinology and Gynecology, University Hospital in Krakow, 31-501 Krakow, PolandClinical Department of Gynecological Endocrinology and Gynecology, University Hospital in Krakow, 31-501 Krakow, PolandDepartment of Gynecology and Obstetrics, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Krakow, PolandDepartment of Gynecology and Obstetrics, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Krakow, PolandDepartment of Gynecology and Obstetrics, Faculty of Medicine, Jagiellonian University Medical College, 31-501 Krakow, PolandBackground: Pain accompanying office hysteroscopy, possibly aggravated by urogenital atrophy, is the most common reason for its discontinuation. The aim was to evaluate the effectiveness of vaginal estriol and hyaluronic acid to facilitate the office hysteroscopy in peri and postmenopausal women. Methods: A prospective cohort study involved women aged 45–90 years subjected to office hysteroscopy. Women were assigned to three study arms: (A) 0.5 mg of estriol in vaginal cream twice daily for 10 days pre-procedure, (B) 5 mg of hyaluronic acid in vaginal gel twice daily for 10 days pre-procedure, (C) no medication. The following endpoints were compared: pain accompanying the procedure, need for cervical dilation, time of cervical passage, incidence of severe urogenital atrophy, and vaso-vagal reaction. Results: There were no significant differences between the arms in terms of pain intensity during (p = 0.93) and after the procedure (p = 0.17), need for cervical dilation (p = 0.5), cervical passage time (p = 0.1), severe urogenital atrophy (p = 0.15), and vaso-vagal reaction (p = 0.29). Conclusions: Despite unfavorable conditions in peri and postmenopausal women, cervical preparation in the above regimens did not seem to bring clinically significant benefits. Clinical Trial Registration: The study was registered under the number NCT05783479 in the Protocol Registration and Results System database (https://clinicaltrials.gov/). The database used for the study was made available in Harvard Dataverse (https://doi.org/10.7910/DVN/HSWURD).https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009194menopauseoffice hysteroscopyestriolhyaluronic acid
spellingShingle Iwona Gawron
Rafał Baran
Kamil Derbisz
Andrzej Zmaczyński
Robert Jach
Miłosz Pietrus
Does Vaginal Estriol or Hyaluronic Acid Facilitate Office Hysteroscopy in Peri and Postmenopause? A Prospective Cohort Study
Clinical and Experimental Obstetrics & Gynecology
menopause
office hysteroscopy
estriol
hyaluronic acid
title Does Vaginal Estriol or Hyaluronic Acid Facilitate Office Hysteroscopy in Peri and Postmenopause? A Prospective Cohort Study
title_full Does Vaginal Estriol or Hyaluronic Acid Facilitate Office Hysteroscopy in Peri and Postmenopause? A Prospective Cohort Study
title_fullStr Does Vaginal Estriol or Hyaluronic Acid Facilitate Office Hysteroscopy in Peri and Postmenopause? A Prospective Cohort Study
title_full_unstemmed Does Vaginal Estriol or Hyaluronic Acid Facilitate Office Hysteroscopy in Peri and Postmenopause? A Prospective Cohort Study
title_short Does Vaginal Estriol or Hyaluronic Acid Facilitate Office Hysteroscopy in Peri and Postmenopause? A Prospective Cohort Study
title_sort does vaginal estriol or hyaluronic acid facilitate office hysteroscopy in peri and postmenopause a prospective cohort study
topic menopause
office hysteroscopy
estriol
hyaluronic acid
url https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009194
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