Clinical evidence regarding spermidine-hyaluronate gel as a novel therapeutic strategy in vestibulodynia management

To evaluate the efficacy of a topical gel containing a spermidine-hyaluronic acid complex as a stand-alone or combined treatment for vestibulodynia: this is the objective of the prospective observational study coordinated by Filippo Murina, head of the Lower Genital Tract Pathology Unit and Menopause Center at Vittore Buzzi Hospital, University of Milan. Professor Alessandra Graziottin and Professor Rossella Nappi, full professor of Obstetrics and Gynecology at the University of Pavia, also participated in the study.
Vestibulodynia (VBD) represents a summation and overlapping of trigger factors (infections, hormonal disturbances, allergies, genetic aspects, psychological vulnerability, and others) with broad individual variability.
The multicenter study was conducted on 154 women; treatment consisted of 8 weeks of gel applications. Symptom assessments included:

• dyspareunia and vulvovaginal pain/burning, by a visual analog scale (VAS);
• vestibular trophism, by a vestibular trophic health score (VeTH);
• microscopic conditions of the vulva, through vulvoscopy;
• pelvic floor hypertonicity, by a physical graded assessment.

The main results are the following:

• the 154 patients treated with the gel showed significant improvements in all parameters assessed;
• dyspareunia and vulvovaginal pain/burning scores decreased by 33.5% and 46.5%, respectively.

The gel cannot replace other recommended therapies, but it can contribute to substantial improvement in any aspect of the condition.