Modern methods of treating vaginal dryness and atrophy

Vaginal dryness is a prevalent and multifactorial condition affecting women across all age groups. Although most common in peri- and postmenopausal populations, it is also observed in younger women due to hormonal imbalances, endocrine disorders (e.g., polycystic ovary syndrome, type 2 diabetes), autoimmune diseases, infections, pharmacotherapy (e.g. selective serotonin reuptake inhibitors, hormonal contraceptives, oncological treatments), and lifestyle factors such as smoking. To review the etiopathogenesis of vaginal dryness and assess current treatment modalities offered by aesthetic and cosmetic gynaecology. A comprehensive analysis of current literature was performed to identify key pathophysiological factors, including oestrogen deficiency, mucosal inflammation, epithelial thinning, and dysbiosis. The clinical efficacy and indications for various treatment modalities were critically assessed. Energy-based treatments (e.g., laser therapy, radiofrequency, high-intensity focused ultrasound, nanoultrasound) have shown promising outcomes in restoring tissue hydration and elasticity, especially in postmenopausal and oncology patients. Injectable therapies - such as hyaluronic acid, platelet-rich plasma, and tropocollagen - support local tissue repair and mucosal regeneration. Hormone replacement therapy remains the standard of care in oestrogen-deficient patients, whereas non-hormonal agents, including topical moisturisers, offer symptom relief in individuals with contraindications to hormonal interventions. Vaginal dryness requires an individualised treatment approach based on the underlying aetiology, hormonal status, and patient-specific factors. Combined or sequential therapies may yield superior outcomes in terms of symptom management and overall patient satisfaction.