A Multilayer Hyaluronic Acid Approach for Vulvovaginal Atrophy: A Case Report

Mazzarella CR*, Marchetti F, Basso M, Lella ED and Maksimova Y

Department of Women's in GVM Santa Maria Hospital, Via Antonio de Ferrariis, Bari, Italy
Plastic Surgeon in Private Practice, Casa di Cura Villa Mafalda, Rome, Italy
International School of Aesthetic Medicine Mediface, Via Galata 37, Genoa, Italy
Independent Researcher, Via Matera 1, Rome, Italy
Center of Aesthetic and Reconstructive Gynecology, European Medical Center, Moscow, Russia

^*Correspondance to: Claudia Mazzarella, 

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Abstract:

Background: Vulvovaginal atrophy is associated with structural and functional changes that may significantly affect quality of life, particularly in patients with limited eligibility for hormonal therapy. Case Presentation: A 48-year-old woman with symptoms of vulvovaginal discomfort and sexual dysfunction was treated using a multilayer approach combining PEGDE-crosslinked and noncrosslinked hyaluronic acid formulations. Results: Improvement in tissue condition was observed using the VeTH scale, with resolution of most parameters. The total FSFI-6 score increased from 6.0 at baseline to 24.0 at 6-week follow-up, indicating a clinically meaningful improvement in sexual function. Conclusion: This case suggests that a multilayer hyaluronic acid hydrogel-based approach may represent a safe and effective non-hormonal option for the management of vulvovaginal dysfunction.

Keywords:

Vulvovaginal atrophy, Hyaluronic acid; Multilayer approach; PEGDE-crosslinked hyaluronic acid; Calcium hydroxyapatite; Sexual function

Cite the Article:

Mazzarella CR, Marchetti F, Basso M, Lella ED, Maksimova Y. A Multilayer Hyaluronic Acid Approach for Vulvovaginal Atrophy: A Case Report. Clin Case Rep Int. 2026; 10: 1772..