{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T15:08:19Z","timestamp":1784300899118,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Postmenopausal women often experience genitourinary symptoms that affect the quality of life (QoL), including dryness in vaginal, atrophy and sexual dysfunction. Pharmacists, as frontline healthcare practitioners, are essential in advising on safe and effective non\u2010hormonal alternatives such as hyaluronic acid (HA); yet, its effects on tolerance and QoL have not been extensively assessed via meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective systematic review and meta\u2010analysis of randomized controlled trials (RCTs) to evaluate the efficacy, safety, and tolerability of HA in improving QoL among postmenopausal women. Only prospective, parallel\u2010group or single\u2010group RCTs were included; no retrospective, cohort, case\u2013control, or non\u2010randomized studies were considered. Eleven studies meet the inclusion criteria in two evidence tiers: placebo\u2010controlled RCTs for primary outcomes and comparative studies. Primary results were vaginal dryness\u2010related QoL and female sexual function index. Vaginal health index (VHI) and tolerability\/safety were designated as secondary outcomes. The risk of bias and GRADE assessments were applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Three placebo\u2010controlled RCTs showed significant improvements in VHI, vaginal dryness\u2010related QoL, and FSFI (with standardized mean difference [SMD]\u2009=\u20093.40, 95% confidence interval [CI]: 2.73 to 4.06;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.00001, SMD\u2009=\u2009\u22120.98, 95% CI: \u22121.24 to \u22120.71;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.00001, and SMD\u2009=\u20090.85, 95% CI: 0.50 to 1.20;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.00001), respectively. In comparative studies, HA was not found to be inferior to active comparators. No serious adverse events were reported (relative risk\u2009=\u20090.35; 95% CI: 0.10 to 1.23;\n                      <jats:italic>P\u2009=<\/jats:italic>\n                      \u20090.10), with moderate heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200952%), and treatment discontinuations were minimal. GRADE evaluation rated the evidence as moderate for vaginal dryness and FSFI but low for VHI and safety outcomes due to heterogeneity and publication bias concerns.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hyaluronic acid is a safe and effective non\u2010hormonal treatment for vulvovaginal discomfort in postmenopausal women, with moderate\u2010quality evidence supporting its benefits for sexual function and QoL. While these findings are encouraging, the variability between research emphasizes the need for more standardized formulations, treatment protocols, and long\u2010term evaluations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70887","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T20:33:46Z","timestamp":1773002026000},"page":"643-654","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hyaluronic acid for vaginal health and quality of life in postmenopausal women: A systematic review and meta\u2010analysis of randomized controlled trials"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8570-4311","authenticated-orcid":false,"given":"Mahmoud","family":"Dahab","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy &amp; Pharmacy Practice, Faculty of Pharmacy Universiti Malaya  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1666-9230","authenticated-orcid":false,"given":"Kalavathy","family":"Ramasamy","sequence":"additional","affiliation":[{"name":"Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy Universiti Teknologi MARA (UiTM) Cawangan Selangor  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8534-2517","authenticated-orcid":false,"given":"Baharudin","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy &amp; Pharmacy Practice, Faculty of Pharmacy Universiti Malaya  Kuala Lumpur Malaysia"},{"name":"Faculty of Pharmacy Universiti Malaya  Kuala Lumpur 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