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Effects of topical dehydroepiandrosterone therapy in women after pelvic organ prolapse surgery
Abstract
OBJECTIVE: Pelvic organ prolapse (POP) occurs predominantly in postmenopausal women. Restoration of the proper estrogenization of vaginal mucosa is important in preoperative and postoperative treatment, increasing the effectiveness of this approach. The objective of this study was the development of intravaginal vaginal suppositories containing DHEA and comparison of the clinical effects of vaginal topical therapy with DHEA, estradiol, or antibiotic after POP surgery. METHOD: Nine types of vaginal suppositories containing 6.5 mg DHEA in different bases were prepared to find optimal formulation for the vaginal conditions. Ninety women referred for POP surgery were randomly assigned to one of three groups receiving topical treatment in the postoperative period (estradiol, DHEA, or antibiotic). On admission to hospital and during follow-up vaginal pH, vaginal maturation index and vaginal symptoms were assessed. RESULTS: Vaginal suppositories with the base made from polyethylene glycol 1,000 without surfactants characterized the highest percentage of the released DHEA. In women treated with topical estradiol or DHEA a significant decrease in the number of parabasal cells, increase in superficial and intermediate cells in the vaginal smears, decrease in vaginal pH, and reduction of vaginal symptoms were observed. CONCLUSIONS: The use of topical therapy with DHEA or the use of topical therapy with estradiol in the postoperative period were both shown to improve maturation index, vaginal pH, and vaginal symptoms. The benefits of topical therapy with DHEA after pelvic organ prolapse repair brings similar results as estradiol, without potential systemic exposure to increased concentrations of sex steroids above levels observed in postmenopausal women.
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“Three trials had a maximum age criterion: Dorairajan 2020 and Nowakowski 2023 had a maximum age of 75 years, while Duarte 2020 excluded women over 80 years.”
From Perioperative interventions in pelvic organ prolapse surgery (2025) · cites this paper as Nowakowski 2023
In the citing paper
“POP surgery with or without vaginal oestrogen: three trials with a total of 409 women (Marschalek 2021; Nowakowski 2023; Rahn 2023).”
From Perioperative interventions in pelvic organ prolapse surgery (2025) · cites this paper as Nowakowski 2023
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Cited by
Sorted by citations
Perioperative interventions in pelvic organ prolapse surgery
Shahid, U., Haya, N., Baessler, K., Christmann-Schmid, C., Yeung, E., Chen, Z., & Maher, C. (2025) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013105.pub2 · Cited by 5
Metadata
- Authors
- Nowakowski, Ł., Gałczyński, K., Dybowski, M., Typek, R., Dawidowicz, A., Miotła, P., Olcha, P., & Rechberger, T.
- Affiliations
- Medical University of Lublin (PL)
- Corresponding author
- Nowakowski, Łukasz
- ORCID
- Venue
- Menopause
- Published
- 2023-06
- Volume
- 30
- Issue
- 6
- Pages
- 629-634
- ISSN
- 1072-3714 (ISSN-L)
- OpenAlex
- W4367671467
- Cited by
- 6
- References
- 0
- Citations by year
- 2026: 3 · 2025: 3
- FWCI
- 1.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Menopause The Journal of The North American Menopause Society (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Keywords
- dehydroepiandrosterone, pelvic organ prolapse, vaginal suppositories, topical estrogen, estradiol, postmenopausal women, vaginal maturation index, vaginal pH, vaginal symptoms, polyethylene glycol base, postoperative care
- MeSH terms
- Anti-Bacterial Agents, Dehydroepiandrosterone, Estradiol, Female, Humans, Suppositories, Pelvic Organ Prolapse
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- The paper
- Nowakowski, Ł., Gałczyński, K., Dybowski, M., Typek, R., Dawidowicz, A., Miotła, P., Olcha, P., & Rechberger, T. (2023). Effects of topical dehydroepiandrosterone therapy in women after pelvic organ prolapse surgery. Menopause. https://doi.org/10.1097/gme.0000000000002183