Лечащий врач · Jun 15, 2026
Current non-hormonal therapy options for vaginal dryness and genitourinary menopausal syndrome: clinical data and practical algorithm
By Gasparyan SA, Varioshkina E
Background. Vaginal dryness is a prevalent condition among women of all ages and can occur not only during menopause as part of the genitourinary syndrome, but also in women of reproductive age, affecting them during the postpartum period and lactation, or due to stress, low body weight, intense physical activity, and the use of certain medications.Reduced vaginal hydration is accompanied by the disruption of the vaginal epithelial barrier, alterations in vaginal pH and microbiota composition, resulting in symptoms of vaginal dryness, burning, pruritus, and dyspareunia, thereby reducing patients' quality of life. Materials and methods. This article provides an analysis of current non-hormonal approaches to the management of vaginal dryness, including the use of moisturizers based on hyaluronic and lactic acids, and phytocomponents. The mechanisms of action of these components, their effects on restoring vaginal mucosal hydration, maintaining physiological pH, and normalizing the vaginal microbiome were reviewed. Particular attention is given to the role of lactic acid as a component of vaginal moisturizers, which promotes the maintenance of an acidic environment and the growth of Lactobacillus. Results. The summarized results of clinical trials revealed reduction in VAS scores, an increase in the vaginal health index, normalization of pH, and the an increase in lactoflora counts after non-hormonal treatment courses. Routine combined use of moisturizers promotes vaginal structural repair and functional recovery and demonstrates a favourable safety profile, including patients with contraindications to hormonal therapy. A practical algorithm for the management of patients with vaginal dryness has been proposed, including diagnosis, selection of non-hormonal therapy, treatment efficacy monitoring, and maintenance therapy to prevent symptom recurrence. Conclusion. The results obtained соnfirm that treatment with non-hormonal moisturizers is an efficient and safe therapeutic option for the improvement of vaginal dryness in women of all ages and can be considered a first-line treatment.