{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T23:22:40Z","timestamp":1772839360402,"version":"3.50.1"},"reference-count":50,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Introduction: The decline of serum estrogen in postmenopausal women leads to several changes in the vulvovaginal and vesicourethral areas, resulting in the genitourinary syndrome of menopause (GSM), characterized by bothersome symptoms such as vaginal atrophy, lack of lubrication, dyspareunia, urgency, dysuria, and recurrent urinary tract infections. Nevertheless, this condition could also be experienced by younger women affected by hormone-dependent tumors. Although topical estrogens are considered \u201cthe gold standard\u201d, hormonal treatments cannot be indicated in cancer survivors. As a result, energy-based devices using radiofrequency and laser technologies have emerged as alternative options. This prospective study aimed to evaluate the benefits of non-invasive monopolar radiofrequency (RF) in women affected by GSM who have contraindications to, did not respond to, or declined local estrogen therapy. Methods: The patients underwent five weekly sessions of second-generation monopolar RF. At baseline and at the fifth session, two validated questionnaires were administered to the patients: the Visual Analogue Scale (VAS) and the Female Sexual Function Index (FSFI-19). On the other hand, the vaginal mucosa status was evaluated by clinicians through the Vaginal Health Index (VHI). At the end of the cycle, the Patient Global Impression of Improvement (PGI-I) questionnaire was collected. Results: Based on 44 patients who completed five sessions of radiofrequency, a significant improvement was observed in sexual function according to the FSFI scale (22.9 vs. 38.6; p &lt; 0.001) and in VVA atrophy symptoms, as documented by the VAS score (223 vs. 125; p &lt; 0.001). The mean VHI score increased by 3 points (p &lt; 0.001). Moreover, according to PGI-I, 96% of patients reported a perceived improvement (PGI-I score \u2264 3). Conclusions: Radiofrequency could provide an innovative and safe therapeutic approach for patients suffering from GSM and VVA, especially when hormonal strategies are unsuitable.<\/jats:p>","DOI":"10.3390\/clinpract15080155","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T15:53:37Z","timestamp":1755705217000},"page":"155","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of Non-Invasive Monopolar Radiofrequency for Treating Genitourinary Syndrome of Menopause: A Prospective Pilot Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7313-7662","authenticated-orcid":false,"given":"Mariachiara","family":"Palucci","sequence":"first","affiliation":[{"name":"Department of Gynecology, Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7495-7185","authenticated-orcid":false,"given":"Marta","family":"Barba","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Cola","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2859-4326","authenticated-orcid":false,"given":"Clarissa","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9149-1081","authenticated-orcid":false,"given":"Desir\u00e8e","family":"De Vicari","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3952-8462","authenticated-orcid":false,"given":"Matteo","family":"Frigerio","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Fondazione IRCCS San Gerardo dei Tintori, University of Milano-Bicocca, 20900 Monza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1097\/GME.0000000000000329","article-title":"Genitourinary syndrome of menopause: New terminology for vulvovaginal atrophy from the International Society for the Study of Women\u2019s Sexual Health and the North American Menopause Society","volume":"21","author":"Portman","year":"2014","journal-title":"Menopause"},{"key":"ref_2","first-page":"e9412","article-title":"The Genitourinary Syndrome of Menopause: An Overview of the Recent Data","volume":"12","author":"Angelou","year":"2020","journal-title":"Cureus"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1089\/jwh.2014.5177","article-title":"The association between vulvovaginal atrophy symptoms and quality of life among postmenopausal women in the United States and Western Europe","volume":"24","author":"DiBonaventura","year":"2015","journal-title":"J. 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