Short-term outcomes and tolerability of a hyaluronic acid-based vaginal gel in the management of genitourinary syndrome of menopause: a retrospective observational study

Background: Genitourinary syndrome of menopause (GSM) is characterized by vulvovaginal dryness, irritation, dyspareunia, and elevated vaginal pH due to estrogen deficiency-related changes of the lower genital tract. Non-hormonal therapies, including hyaluronic acid (HA)-based vaginal gels, are increasingly used to improve local tissue hydration and symptoms. Objective: To assess short-term clinical outcomes and local tolerability associated with a hyaluronic acid-based vaginal gel (Gynexelle Hyalo-Duo) in women with GSM. Methods: This retrospective, single-center observational study included 60 women aged 18-65 years (30 reproductive-age and 30 postmenopausal) managed at Studio Medico Capasso, Naples, Italy. The gel was applied daily for 7 days, followed by three applications per week for 3 weeks. Outcomes included the Vaginal Health Index (VHI), Vulvar Health Index (VuHI), Subjective Evaluation of Specific Symptoms (SESS), and vaginal pH, assessed at baseline (T₀), after 1 week (T₁), and after 4 weeks of treatment (T₂). Results: At T₂, mean VHI increased from 12.7 ± 3.3 to 19.3 ± 4.0 (p < 0.001), VuHI decreased from 5.3 ± 3.8 to 2.5 ± 3.5 (p < 0.001), and SESS improved from 11.8 ± 3.3 to 2.4 ± 3.9 (p < 0.001). Vaginal pH decreased from 6.1 ± 1.0 to 4.7 ± 0.8 (p < 0.001). Improvements were observed in both reproductive-age and postmenopausal women. No adverse events were documented. Conclusion: Short-term use of a hyaluronic acid-based vaginal gel was associated with improvements in vulvovaginal symptoms and vaginal health parameters, with good local tolerability, in a real-world observational setting.