Hybrid high and low molecular weight chains of hyaluronan for clitoral injection is an effective modality treatment for increasing female sexual satisfaction: an interventional, randomized-controlled parallel study

Introduction: Hormonal, behavioral, psychological, surgical, and pharmacopsychological treatment approaches contribute to female sexual dysfunction (FSD). Aim: The study is conducted to assess the effectiveness of hyaluronan high and low molecular weight hybrid cooperative complexes (hybrid H-HA/L-HA) in treating females with SD and to compare the female sexual function index (FSFI), dermatological life quality index (DLQI), and female genital self-image scale (FGSIS) before and after therapy.

Methods: We divided the 60 female participants into two groups. Hybrid H-HA/L-HA was administered to form pili of 0.25 cc around the clitoris in the direction of clock positions of 12, 3, 6, and 9. In Skene's gland; 0.25 cc for each and 0.5 cc into the corpus/body of the clitoris. Two treatments were held 30 days apart.The same procedure was repeated on the control group, but with saline as a placebo.

Outcomes: Women completed self-report questionnaires assessing sexual functioning using the FSFI, DLQI, and FGSIS before and after therapy.

Result: There was a significant (P = 634.152; P < .05) increase in the study group's weekly sexual interactions compared with the controls. The study group showed statistically significant amelioration in desire, arousal, lubrication, orgasm, satisfaction domains, overall score, and a decrease in pain following the first and second injection sessions (P = .014, .031, .003, .001, .011, .004, and .011, respectively). A comparison of the results between the two groups revealed significant improvement were found (P = .025).There were significant improvements in the domains of the FGSIS compared with the controls (P = .026). The study group showed a substantial improvement in satisfaction with the way their genital area looked, comfort level when allowing a sexual partner to view their genital area, belief that their genitals smell perfectly fine without being self-conscious about them, and overall score (P = .022, .031, .003, .001, and .004, respectively) (P < .05).The hybrid H-HA/L-HA sessions resulted in significantly greater positive perceptions and feelings, leisure activities, interpersonal interactions, and general assessments (P = .021, .021, and .020, respectively) (P < .05).

Clinical implications: Female individuals with SD experience sexual improvements after hybrid H-HA/L-HA injection.

Strengths and limitations: This is the first study focusing on female individuals with SD. We recommend conducting the study on a larger population and including their partners.

Conclusion: Hybrid H-HA/L-HA injection for rejuvenating the clitoral injection appears to be a reliable and safe method for enhancing female genital self-image, sexuality, and quality of life.