TOPLINE:

Platelet-rich plasma (PRP) injections into the anterior vaginal wall enhanced sexual function in premenopausal women without severe sexual dysfunction. At 6 months, more than two thirds of women receiving PRP reported improved sexual function compared with approximately one third in the control group.

METHODOLOGY:

• Researchers conducted a single-blind, randomized, placebo-controlled trial at a urogynecology clinic in the US, enrolling 52 sexually active premenopausal women aged 18-50 years without severe sexual dysfunction from June 2023 to September 2024.
• Participants were randomly assigned 1:1 to receive either a one-time PRP injection (2-4 mL) or saline placebo (4 mL) into the distal anterior vaginal wall at three injection sites: 3 cm from the urethral meatus at midline and 1-2 cm to the right and left of midline.
• The primary outcome was change in Female Sexual Function Index (FSFI) score from baseline to 6 weeks after injection, with secondary outcomes including FSFI score change at 6 months, FSFI subdomain scores, Patient Global Impression of Improvement (PGI-I) score, visual analog scale (VAS) pain score, weekly sexual encounters, and adverse events.
• All 52 participants (26 in the PRP group and 26 in the control group) completed 6-week and 6-month follow-up assessments and were included in an intention-to-treat analysis using proportional odds models to compare outcome distributions over time between treatment arms.

TAKEAWAY:

• Women treated with PRP had a greater increase in median total FSFI score at 6 weeks (2.2; 95% CI, 0.6-4.8) and 6 months (1.6; 95% CI, -0.2 to 4.1) than the control group at 6 weeks (0.3; 95% CI, -1.7 to 2.3) and 6 months (0.8; 95% CI, -1.1 to 2.7), with P = .05 at both timepoints.
• The percentage of participants reporting improved sexual function based on PGI-I score was higher in the PRP group at 6 weeks (69.2% vs 42.3%; P = .05) and at 6 months (69.2% vs 34.6%; P = .01).
• Women in the PRP group showed improved FSFI subscale scores for desire (6-week change, 0.6; 95% CI, 0.1-1.1), arousal (0.8; 95% CI, 0.2-1.2), lubrication (0.7; 95% CI, 0.2-1.2), and orgasm (1.0; 95% CI, 0.4-1.5), although these changes were not significantly different from those in the control group after adjustment for multiple testing.
• No serious adverse events were reported in either group, though the median VAS pain score during treatment was higher in the PRP arm (5.5; 95% CI, 4.0-6.0) than in the control group (3.0; 95% CI, 2.0-4.0; P < .001).

IN PRACTICE:

“This randomized controlled trial provides compelling data demonstrating greater improvement in sexual function with anterior wall PRP injections compared with control in sexually active premenopausal women without severe sexual dysfunction,” wrote the authors of the study.

SOURCE:

The study was led by Bayley Clarke, MD, Section of Urogynecology and Reconstructive Pelvic Surgery, University of Colorado Anschutz, Aurora, Colorado. It was published online in Obstetrics & Gynecology.

LIMITATIONS:

According to the authors, the study has several limitations including a relatively small sample size and specified exclusion criteria such as postmenopausal status and baseline FSFI score < 14.4, which may limit the generalizability of results to postmenopausal women or those with more severe sexual dysfunction. All injections were performed at a single center using the same PRP preparation method, further limiting generalizability. Additionally, the person performing the injections was not blinded to the treatment arm, potentially introducing bias. The authors noted that total FSFI and all subdomain scores peaked at 6 weeks and were lower at 6 months, suggesting PRP may be a temporary therapy requiring reinjection after several months to maintain effect.

DISCLOSURES:

The SHE+ Foundation provided financial assistance for the study. The funder reported not being involved in study design, data collection, analysis, manuscript preparation, or the decision to publish. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.