Introduction
urogenital atrophy, hormone-dependent cancers, breast/endometrial cancer, dryness
URINARY TRACT INFECTIONS, VASCULARIZATION, CONTRACTION, ESTROGEN DEFICIENCY, HYPOESTROGENISM, ATROPHIC
During menopause, estrogen deficiency induces atrophic changes in the urogenital tract epithelium, resulting in vaginal discomfort, dryness, burning, irritation/pain, and this can be accompanied by an increased occurrence of sexual and urinary discomfort and urinary tract infections.Hypoestrogenism also provokes alteration in collagen type I fibrils to collagen type III fibrils ratio with loss of their trabecular disposition, decreased quantity of elastic fibers, reduced vascularization, and thinning and flattening of the vaginal epithelium, which can superficially turn into a keratinized layer.Several strategies have been proposed to improve the symptoms of menopause. Hormonal (estrogens and androgens) and non-hormonal (lubricants and long-acting vaginal moisturizers) therapies are most frequently employed. Vaginal estrogen is the acknowledged gold standard for the treatment of urogenital atrophy. However, non-hormonal approaches can be beneficial in cases where hormonal therapy is contraindicated, such as in women with hormone-dependent cancers (breast/endometrial cancer) or when the woman chooses to avoid hormonal exposure.The energy-based devices in gynecology have been used in the last years; the most common are laser and radiofrequency (RF). The COThe thermal effects of radiofrequency induce collagen denaturation, promoting the immediate and effective contraction of its fibers, activating fibroblasts, and leading to neocolagenesis, the reorganization of collagen fibers, and subsequent tissue remodeling.