Oral Collagen Peptides and Vulvovaginal Radiofrequency Therapy for Genitourinary Syndrome of Menopause: A Pilot Randomized Study

<b>Background/Objectives</b>: Genitourinary syndrome of menopause (GSM) encompasses a variety of symptoms associated with estrogen deficiency, affecting the genitourinary tract. Effective management often requires a multifaceted approach. Although radiofrequency (RF) treatment has been explored as a non-hormonal intervention for GSM, evidence remains limited and inconclusive. Oral collagen peptides have demonstrated systemic tissue benefits in dermatological studies, but with effects that are not yet well understood in the context of GSM. This pilot study investigated whether combining RF with an oral supplementation containing specific bioactive collagen peptides and ultra-low-molecular-weight hyaluronic acid would provide superior symptom relief compared to RF alone in women with GSM. <b>Methods</b>: Twenty menopausal women were randomized into two groups: Group 1 (n = 10) received vulvovaginal RF treatment every two weeks for two months; Group 2 (n = 10) received the same RF treatment alongside daily oral supplementation for four months. Subjective symptoms, objective signs, and vaginal pH were assessed at baseline (T0), post-RF treatment (T1), and three months post-RF treatment (T2), employing a two-way repeated-measures ANOVA to assess differences between groups over time. <b>Results</b>: Both groups showed substantial improvements in all the clinical parameters evaluated at T1 and T2 compared to T0. However, the magnitude of such improvements was higher among patients from Group 2, who achieved better outcomes at T2 compared to patients from Group 1, with differences being statistically significant regarding subjective symptoms (<i>p</i> < 0.001), objective signs (<i>p</i> < 0.001), and vaginal pH (<i>p</i> = 0.015), thus demonstrating the sustained benefits of the combination therapy over RF treatment alone during the follow-up time. <b>Conclusions</b>: Combined treatment with vulvovaginal RF and food supplements improved the signs and symptoms of GSM, and compared to RF treatment alone, it enhanced and maintained the benefits in a three-month follow-up period.