{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T22:32:19Z","timestamp":1787956339665,"version":"build-2784847793"},"reference-count":32,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T00:00:00Z","timestamp":1625443200000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["436740\/2018-4."],"award-info":[{"award-number":["436740\/2018-4."]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,6,6]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Menopause is a physiological and progressive phenomenon secondary to decreased ovarian follicular reserve. These changes have consequences: vaginal dryness, dyspareunia, discomfort, burning and irritation, vulvovaginal pruritus, dysuria and increased frequency of genitourinary infections. The therapy more suitable for vaginal symptoms in postmenopause yet is the use of a topical hormone. However, the prescription of topical oestrogens should also be avoided in women with a history of breast cancer, oestrogen-sensitive tumours and thromboembolism, emphasising the necessity of alternative treatments. Recently, physical methods, such as laser and radiofrequency (RF), in their non-ablative, ablative and microablative forms have been used in the vaginal mucosa to promote neocolagenesis and neoelastogenesis. This randomised study aims to compare the efficiency of microablative fractional RF (MAFRF) treatment with vaginal oestrogens and no treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analyses<\/jats:title>\n                    <jats:p>This randomised, controlled clinical intervention trial with an open label design comparing the treatment of MAFRF with vaginal oestrogens and no treatment. Four important moments were considered to evaluate treatment results (T0, T1, T2 and T3). The primary outcome includes vulvovaginal atrophy (vaginal pain, burning, itching, dryness, dyspareunia and dysuria), and the secondary outcomes will be sexual function, vaginal health (epithelial integrity, vaginal elasticity, moisture, fluid volume and vaginal pH) and quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Due to the nature of the study, we obtained approval from the ethics committee. All participants must sign an informed consent form before randomisation. The results of this study will be published in peer-reviewed journals. The data collected will also be available in a public repository of data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>RBR-94DX93.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-046372","type":"journal-article","created":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T12:02:30Z","timestamp":1625486550000},"page":"e046372","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Microablative fractional radiofrequency for the genitourinary syndrome of menopause: protocol of randomised controlled trial"],"prefix":"10.1136","volume":"11","author":[{"given":"Ayane Cristine Alves","family":"Sarmento","sequence":"first","affiliation":[{"name":"Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fab\u00edola S","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Clinical Analysis and Toxicology, Federal University of Rio Grande do Norte, Natal, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Paula Ferreira","family":"Costa","sequence":"additional","affiliation":[{"name":"Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kleyton Santos","family":"Medeiros","sequence":"additional","affiliation":[{"name":"Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janaina Cristina","family":"Crispim","sequence":"additional","affiliation":[{"name":"Department of Clinical Analysis and Toxicology, Federal University of Rio Grande do Norte, Natal, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8351-5119","authenticated-orcid":false,"given":"Ana Katherine","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal, Brazil"},{"name":"Department of Obstetrics and Gynaecology, Federal University of Rio Grande do Norte, Natal, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,5]]},"reference":[{"key":"2025121510575065000_11.7.e046372.1","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0b013e3182a122c2"},{"key":"2025121510575065000_11.7.e046372.2","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.maturitas.2014.07.013","article-title":"Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the study of women\"s sexual health and the North American menopause Society","volume":"79","author":"Portman","year":"2014","journal-title":"Maturitas"},{"key":"2025121510575065000_11.7.e046372.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.07.045"},{"key":"2025121510575065000_11.7.e046372.4","doi-asserted-by":"crossref","first-page":"162","DOI":"10.3109\/13697137.2015.1132199","article-title":"The role of local estrogen therapy in the management of pelvic floor disorders","volume":"19","author":"Tzur","year":"2016","journal-title":"Climacteric"},{"key":"2025121510575065000_11.7.e046372.5","first-page":"CD001500","article-title":"Local oestrogen for vaginal atrophy in postmenopausal women","volume":"8","author":"Lethaby","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121510575065000_11.7.e046372.6","doi-asserted-by":"crossref","unstructured":"Filippini M , Luvero D , Salvatore S . 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