PlateletRich Plasma Therapy in Postmenopausal Women with Vulvovaginal Atrophy and Lichen Sclerosus: A Clinical and Histological Study

Background: Vulvovaginal atrophy (VVA) and lichen sclerosus (LS) represent chronic, progressive manifestations of the genitourinary syndrome of menopause (GSM) that significantly affect postmenopausal women’s quality of life (1,2). Conventional treatments—topical corticosteroids or local estrogen—often provide only temporary symptomatic relief and may be contraindicated or poorly tolerated (3,4). In recent years, platelet-rich plasma (PRP), an autologous concentrate of platelets and growth factors, has emerged as a promising regenerative therapy for mucocutaneous disorders (5–7). Objective: To evaluate the clinical and histological outcomes of autologous PRP injections in postmenopausal women with VVA and LS and to assess safety, tolerability, and hormonal neutrality. Methods: Thirty postmenopausal women aged 45–60 years received two submucosal PRP injections at 14-day intervals. Symptom severity was measured using a 4-point Likert scale; histological changes were assessed by epithelial thickness, fibroblast proliferation, collagen remodeling, vascular density, and inflammatory infiltrate (8,9). Serum FSH and estradiol levels were monitored to exclude systemic hormonal effects. Results: Histologic evaluation showed restoration of stratified squamous epithelium, reappearance of rete ridges, increased fibroblast and vascular density, and decreased inflammatory infiltrate (10,11). Clinically, > 80 % of participants reported substantial improvement in dryness, itching, and dyspareunia (12). No adverse events or systemic hormonal alterations occurred (13). Overall patient satisfaction averaged 8.5 ± 1.1 on a 0–10 visual analog scale (14). Conclusion: PRP therapy induced measurable tissue regeneration and symptomatic improvement without systemic hormonal involvement. Findings support PRP as a safe, hormone-free, regenerative option for GSM and LS management in postmenopausal women (15).