To accept or to restore. Using hyaluronic acid to treat the genital area: A gynaecologist’s real-life experience. 

At the root of libido issues: pain

The alteration of the vaginal mucous membrane with its loss of suppleness and hydration leads to pain during inter-course. There is, however, a therapeutic solution: hyaluronic acid. This molecule, by restoring the vagina’s hydration and suppleness, improves sexual function and quality of life. Not only for women post-menopause, who lack oestrogen, but also for younger women suffering from vulvar trauma (childbirth) or after breast cancer (chemotherapy, hormone therapy). 

After the menopause, the ovaries stop secreting oestrogen. The absence of periods is accompanied by genital issues due to oestrogen defi ciency: the vaginal mucous membrane becomes dehydrated. Sexual intercourse becomes uncomfortable, even painful, which leads to a lack of libido, problems with sexual function and overall quality of life. This same phenomenon of oestrogen deprival can sometimes occur in younger women who have suffered from breast cancer. Their treatments (hormone therapy, chemotherapy) deprive them of oestrogen, just like after the menopause.

How can you have a fulfilling sex life if it causes you pain?

This pain has a serious impact on their sex drive. These women’s bodies are betraying them, which is a source of anxiety. They lose the points of reference they have constructed throughout their life and no longer recognise themselves. What is more, they have to deal with this problem on their own, because it is a huge TABOO!

WHO DARES talk to their doctor about pain during sex?

Doctors, gynaecologists and oncologists must talk to their patients in order to lift this taboo. And I would like to tell young women that libido issues are not that rare: in my daily work, I meet women who either suffer from residual pain due to an episiotomy during child-birth, who take progesterone only contraception which dries out the vaginal mucous membrane, or young women with no clear cause. They experience pain during intercourse which, even at their age, can affect their libido.

A therapeutic innovation: hyaluronic acid

The injection of a hyaluronic acid called Desiral into the genital area can quickly rehydrate the vaginal mucous membrane. This molecule has a powerful hydrating power. This treatment is effective because it acts directly where the pain is. Most pain during sex is orificial: experienced during penetration.

The hyaluronic acid injections are performed in the lower third of the vagina and into the vestibule. Its use is very straightforward, providing the doctor has undergone specific training and respects the basic sterility rules. The treatment is carried out in a doctor’s surgery, under local anaesthetic, and takes about half an hour. It is completely pain free. This product was designed by a French laboratory: Vivacy. I published the first study into this subject: 150 patients treated using Desiral. The benefits were immediate: a feeling of comfort is felt after the very first session. Then, after five months, 75% of them said they were very satisfied with the results. This study showed the fast effectiveness of hyaluronic acid.

Unfortunately, the benefits do not always last. A second injection is recommended after five months, which potentiates the results, then a third session can be carried out after 15 months. I started doing this treatment in 2015, in women who had been treated for breast cancer with chemotherapy and hormone therapy. Even the younger ones suffered from sexual issues. The spectacular benefits convinced me that this treatment should be rolled out for any women who are suffering after the menopause, or even younger women. Desiral is an important therapeutic innovation for gynaecology. It improves sexual function, libido and overall quality of life for both women and couples. Unfortunately, this treatment is still only carried out on the small minority of the female population who have heard about it! 

Dr Pascale SABBAN SERFATI:  Obstetrician/gynaecologist in Paris, graduate in Genital Aesthetic Medicine from the Henri Mondor University Hospital in Créteil. Author of the first large-scale study into treating the genital area with hyaluronic acid, in post-breast cancer patients with sexual side effects. Author of a number of publications and articles about treating vulvar-vaginal atrophy using hyaluronic acid (ITO, reality in obstetrics/gynaecology, reality in plastic surgery, letter from a specialist breast surgeon, etc.). Speaker at a number of French and international aesthetic medicine congresses (Imcas, AIME, SFME, etc.) and cancerology congresses (Focus, French-speaking higher breast cancer committee, etc.). Presenter of round tables in Cancerology Centres within the framework of “Pink October”. Trains aesthetics doctors and gynaecologists in France and abroad.

More informations: doctolib.fr/gynecologue-obstetricien/paris/pascale-sabban-serfati 

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