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NCT Number: NCT06925139

Efficacy of Non-Ablative Radiofrequency on Vaginal and Sexual Health in Postmenopausal Women

This study will test if non-ablative monopolar radiofrequency can help improve vaginal tissue and reduce symptoms of Genitourinary Syndrome of Menopause (GSM) in postmenopausal women. The study is a double-blind, randomized clinical trial. The study will examine the impact of the treatment on sexual function, vaginal health, and quality of life over an extended period. There will be two groups in the study: one will receive the non-ablative monopolar radiofrequency treatment, and the other will receive the placebo treatment. Participants will have six treatment sessions and will be checked at the start, end, and three months post-treatment.

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Key information

Age range

40 year–65 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

University of Castilla-La Mancha

Toledo, 45000, Spain

About this study

The purpose of this study is to evaluate the efficacy of non-ablative monopolar radiofrequency (RF) treatment in improving vaginal tissue regeneration and alleviating symptoms of Genitourinary Syndrome of Menopause (GSM) in postmenopausal women. This double-blind, randomized clinical trial will include two groups: one receiving the active RF treatment and the other receiving a placebo treatment. The study will include six treatment sessions for each participant, with evaluations conducted at baseline, at the end of the treatment period, and three months post-treatment.

Participants will be postmenopausal women who have experienced more than one year of amenorrhea and exhibit symptoms of GSM, such as vaginal dryness, irritation, and sexual dysfunction. The primary outcome measures will include improvements in vaginal health assessed through clinical examination and patient-reported outcomes related to sexual function and quality of life.

Secondary outcome measures will involve the analysis of vaginal pH, the maturation index of vaginal epithelial cells, and any adverse events reported during the study. The intervention involves the use of a non-ablative monopolar RF device applied intracavitarily. The placebo group will undergo the same procedure without the active RF component.

The study is conducted in accordance with ethical standards and has been reviewed and approved by the Ethics Committee for Clinical Research with Medicines of the City of Toledo. Data will be collected and analyzed to determine the effectiveness of the treatment in comparison to the placebo, and results will contribute to the understanding of non-ablative RF treatments in menopausal health.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age between 40 and 65 years.
  • Postmenopausal women (defined as no menstrual period for at least 12 months).
  • Experiencing symptoms of Genitourinary Syndrome of Menopause (GSM), such as vaginal dryness, irritation, or discomfort.
  • Experiencing discomfort or complaints during vaginal penetration. Engaging in sexual activity (at least once a month).
  • Willing to participate in the study and sign the informed consent form.

Exclusion criteria

  • Presenting with active vaginal infections.
  • Presence of neurological, neoplastic, or sexually transmitted diseases.
  • Presenting with vulvodynia or vaginismus.
  • Prolapse grade 2 or higher.
  • Presenting with altered sensitivity in the pelvic area.
  • Being a pacemaker carrier or having any device that contains batteries.
  • Hormonal treatment with estrogens in the last 3 months.
  • History of radiotherapy in the pelvic area.
  • Recent pelvic surgery (within the last 6 months).
  • Being on anticoagulant treatment.
  • Having undergone laser treatment in the pelvic area or ablative vaginal rejuvenation in the last 6 months.
  • Cognitive impairment that prevents answering the questionnaires.

Treatment and study plan

Non-ablative monopolar radiofrequency treatment

Device

Protocol for the experimental group:

Tissue preparation phase: 5 minutes with the circular resistive monopolar electrode, applying slow circular or semicircular movements in the perineal area. The temperature will be gradually increased based on the patient's temperature perception, ensuring it remains comfortable (approximately 5 out of 10).

Main phase: 10 minutes using the intracavitary capacitive electrode connected to the PLUMA handle, lightly resting it on the tissues and continuously moving the electrode. The temperature should reach 40-42°C in the tissue and be maintained for at least 10 minutes.

Final phase: 5 minutes with the circular resistive monopolar electrode, applying it similarly to the preparatory phase, with a subthermal effect, reaching a self-reported thermal sensation of 3 to 4 out of 10.

Protocol for the sham group: this group will receive the same treatment protocol that treatment group, but without the application of heat.

Primary outcomes

  1. Change in Female Sexual Function Index (FSFI)

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    Multidimensional questionnaire evaluates sexual function over the past 4 weeks. The total score ranges from 2.0 (severe dysfunction) to 36.0 (no dysfunction). Sexual dysfunction was defined as a score equal to or below 26.55

  2. Change in Vaginal Health Index (VHI)

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    A tool that evaluates five parameters: vaginal elasticity, vaginal secretion (type and consistency), pH, mucosal epithelial integrity, and vaginal moisture. Each parameter was scored on a scale from 1 (most unfavorable condition) to 5 (optimal condition), with a maximum possible score of 25 points. In cases where the score was below 15, the vagina was considered atrophic.

Secondary outcomes

  1. Change in sexual desire

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    Assessed by Female Sexual Function Index in individual domain of sexual desire. Score from 1,2 (worst) to 6 (best)

  2. Change in sexual arousal

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    Assessed by Female Sexual Function Index in individual domain of sexual arousal. Score from 0 (worst) to 6 (best)

  3. Change in sexual lubrication

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    Assessed by Female Sexual Function Index in individual domain of sexual lubrication. Score from 1,2 (worst) to 6 (best)

  4. Change in sexual orgasm

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    Assessed by Female Sexual Function Index in individual domain of sexual orgasm. Score from 0 (worst) to 6 (best)

  5. Change in sexual satisfaction

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    Assessed by Female Sexual Function Index in individual domain of sexual satisfaction. Score from 0.8 (worst) to 6 (best)

  6. Change in sexual pain

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    Assessed by Female Sexual Function Index in individual domain of sexual pain. Score from 0 (the worst possible pain) to 6 (no pain).

  7. Change in vaginal Elasticity

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    Assessed by Vaginal Health Index in individual domain of vaginal elasticity. Score from 1 (most unfavorable condition) to 5 (optimal condition)

  8. Change in Vaginal secretion

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    Assessed by Vaginal Health Index in individual domain of vaginal secretion. Score from 1 (most unfavorable condition) to 5 (optimal condition)

  9. Change in vaginal pH

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    Assessed by Vaginal Health Index in individual domain of vaginal pH. Score from 1 (most unfavorable condition) to 5 (optimal condition)

  10. Change in vaginal Ephitelial integrity

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    Assessed by Vaginal Health Index in individual domain of vaginal ephitelial integrity. Score from 1 (most unfavorable condition) to 5 (optimal condition)

  11. Change in vaginal Moisture

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    Assessed by Vaginal Health Index in individual domain of vaginal moisture. Score from 1 (most unfavorable condition) to 5 (optimal condition)

  12. Change in Vaginal Maturity Index

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    The proportion of parabasal, intermediate, and superficial cells in each 100 cells counted on a smear of the upper two-thirds of the vagina.

  13. Change in Status Estrogen

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    This index will be calculated using Meisels' formula: (% intermediate cells × 0.5 + % superficial cells).

  14. Change in Vaginal Laxity Questionnaire (VLQ)

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    7-point Likert-type subjective scale, ranging from very loose to very tight. Scores below 4 (neither loose nor tight) indicate vaginal laxity.

  15. Change in Pain assessed by NRS

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    Pain intensity perceived during the insertion of vaginal dilators of varying diameters (ranging from 20 to 30 mm) will be assessed using the Numeric Rating Scale, where 0 indicates no pain and 10 represents the worst possible pain.

  16. Change in Urinary Symptoms by International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form

    Time frame: Baseline, end of treatment period (5 weeks), and three months post-treatment.

    It is a brief 4-item questionnaire designed to assess the frequency, severity, and impact of urinary incontinence on quality of life.

  17. Change in Health- related quality of Life by SF-12

    Time frame: Baseline, end of treatment period (6 weeks), and three months post-treatment.

    It consists of 12 items that yield two summary scores: physical and mental components. The response options follow a Likert-type scale that measures either intensity or frequency. Scale scores range from 0 to 100, with 0 indicating the worst health status and 100 the best.

Sponsors and collaborators

Lead sponsor

University of Castilla-La Mancha

Other

Registry information

Official study title

Efficacy of Non-Ablative Radiofrequency on Vaginal and Sexual Health in Postmenopausal Women: a Randomized Clinical Trial

Important dates

Study start
2024
Primary completion
2024
Study completion
2025
First posted
Apr 13, 2025
Registry last updated
Apr 13, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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