Table 4.

Polynucleotides for Vulvar and Vaginal Rejuvenation.

Study	Purpose/Objective	Study Design	Sample Size	Treatment	Outcomes	Level of Evidence
Palmieri et al. [47]	Evaluate efficacy and safety of PN and HA for treating postmenopausal labia majora	Prospective observational study	20	PN and HA injections in labia majora	Significant improvements in vaginal dryness, itching, and atrophy; minimal adverse reactions	IV
Palmieri et al. [22]	Effects of PN-HPT on postmenopausal sexual life disruption	Retrospective analysis	20	Vulvar rejuvenation with PN-HPT	Improvements in vulvar elasticity, skin hydration, vaginal dryness; 80% reported improved sexual function	IV
Angelucci et al. [48]	Efficacy of Hyal/PN in treating vulvovaginal atrophy (VVA)	Pilot study	15	Single injection of Hyal/PN	Improvements in VVA symptoms (vaginal dryness, itching, dyspareunia), increased vaginal pH and mucosa thickness, 86% reported improved sexual function and satisfaction	IV