# Vulvovaginal Collagen Injection as a Regenerative Strategy in Genitourinary Syndrome of Menopause: Results of a Pilot Study

## TL;DR

This pilot study shows that collagen injections in the vulvovaginal area may safely reduce pain and improve symptoms in menopausal women with GSM who do not respond to traditional treatments.

## Contribution

The study introduces vulvovaginal collagen injections as a novel regenerative treatment for GSM with promising preliminary results.

## Key findings

- Baseline pain decreased significantly from 5.9 to 0.8 three months after collagen injections.
- Pain during intercourse dropped from 8.7 to 2.0, and all patients reported improvement in at least one symptom domain.
- 80% of patients felt 'much better' and 20% 'moderately better' with no significant adverse effects.

## Abstract

Background/Objectives: Genitourinary syndrome of menopause (GSM) is a common and under-diagnosed condition that significantly affects the quality of life of post-menopausal women. Conventional treatments, especially those based on estrogens, have limitations, which has prompted the search for alternative therapies in the field of regenerative medicine. In this context, intradermal injectable collagen, with regenerative and analgesic properties, could represent an innovative option. This study aims to evaluate the efficacy and safety of multipoint intradermal injections of collagen (MD-Tissue) in the treatment of GSM refractory to conventional first-line therapy. Methods: A retrospective study was conducted in 20 patients diagnosed with GSM. Intradermal injections of collagen were administered in the vulvovaginal region. Clinical outcome was assessed using the Visual Analog Scale (VAS) for baseline pain and dyspareunia, the Vaginal Health Index (VHI), the Vulvar Health Index (vHI), the Vulvovaginal Symptoms Questionnaire (VSQ) and the Clinical Global Impression scale (CGI). Results: Three months after end of injections, baseline pain measured using the VAS was significantly reduced from a mean of 5.9 to 0.8 (p < 0.001), and pain during intercourse decreased from 8.7 to 2.0 (p < 0.001). Significant improvements were also observed in the tissue parameters of VHI and vHI. In the VSQ, 100% of patients reported improvement in at least one domain, including itching, dryness, burning, and social and sexual impact. According to the CGI scale, 80% reported feeling ‘much better’ and 20% ‘moderately better’. No relevant adverse effects were reported. Conclusions: Intradermal vulvovaginal collagen injections appear to be a safe and potentially effective intervention in improving pain and other symptoms of GSM, within the regenerative medicine approach. These preliminary results justify prospective studies, with larger sample sizes and long-term follow-up, to confirm and consolidate clinical utility.