Written by Mercey Livingston
Hyaluronic acid is one of the most popular ingredients in skincare products, but it turns out the benefits extend well beyond your face. Many women experience vaginal dryness and painful sex as they go through menopause, but traditionally estrogen creams are the main treatment option. Hyaluronic acid is a clinically studied, effective, naturally occurring ingredient used to manage vaginal dryness and the associated symptoms like burning, irritation, and painful sex. Hyaluronic acid offers relief without having to use hormone therapy – making it an alternative for women.
“Hyaluronic acid is naturally produced in the body. This is a key molecule involved in maintaining the skin’s moisture. Hyaluronic acid has the unique capacity to bind to and retain water, however, with age, comes natural depletion,” says Bonafide Chief Medical Officer, Dr. Alyssa Dweck. "A steep decline begins after the age of 40 – this is due to decreased production of the hyaluronic acid by our cells, " says Dr. Dweck. Keep reading for everything you need to know about hyaluronic acid, including the ingredient benefits and how it works to relieve vaginal dryness.
What Is Hyaluronic Acid and How Is It Made?
Hyaluronic acid is found naturally throughout the body, including in the skin and joints. It has the natural ability to bind and retain water, which is why it's so great for hydrating the skin. The word "acid" might make you think that it's a harsh ingredient, but it's actually very hydrating.
In order to create Revaree®, a hormone-free, steroid-free and paraben-free vaginal insert that contains hyaluronic acid, Bonafide uses a unique, proprietary process to create this key ingredient without any animal-based ingredients or by-products.
"Traditionally, hyaluronic acid was sourced from rooster combs, the red part of the top of the rooster head, which is kind of odd, but it's super high in hyaluronic acid," says Bonafide Chief Science Officer, Jim Komorowski. "More recently, over years, technology has found a way to have it synthesized from bacteria. And so, you can microbially generate and mass produce hyaluronic acid," says Komorowski.
According to Komorowski, hyaluronic acid can be somewhat difficult to absorb into the skin. However, Bonafide uses a special type of hyaluronic acid called sodium hyaluronate, that is more easily absorbed into the dermal layer of skin but does not get absorbed into the bloodstream.
Using Hyaluronic Acid for Vaginal Dryness Relief
The hormonal changes associated with menopause can cause a lot of things to change – including sex and vaginal comfort. Reduced estrogen levels can cause vaginal dryness and discomfort with sex, which is why a topical moisturizer can help reduce dryness and pain. “Vaginal dryness naturally occurs with diminished estrogen levels. Less estrogen, which happens during menopause leads to less blood flow to the vaginal tissue. Less blood flow means less natural lubrication and potential for uncomfortable symptoms including dryness and painful intercourse," says Dr. Dweck.
Many women have traditionally used estrogen prescription products to help remedy vaginal dryness, but some women, like those with a history of some types of cancer, may not be able to or want to use hormonal therapies. “First, hyaluronic acid has been shown in multiple studies to be quite effective in treating dryness and painful sex and is safe for topical use in the vagina.1 In fact, studies2 have suggested equal efficacy of hyaluronic acid to vaginal estrogen without any hormone exposure," says Dr. Dweck. "Many women cannot or will not take hormone therapy. For example, those with hormonally sensitive cancers, such as breast or uterine cancers, will typically avoid estrogen exposure.”
One of the benefits of using hyaluronic acid is that can be repeatedly used safely when taken as directed. "Vaginal moisturizers, including those made with hyaluronic acid can be used indefinitely. Unlike hot flashes or night sweats, vaginal dryness related to menopause will only persist or worsen with time if not managed regularly. The longer a moisturizer is used, the better the outcome," says Dr. Dweck. "Estrogen cream is effective and recommended indefinitely; however, that is a hormonal option with associated caveats." Another added benefit of using an insert like Revaree, is that it's less messy than gels or products with applicators.
How Does Hyaluronic Acid Work?
Revaree is a simple to use insert that is applied vaginally. "Once the suppository melts, you're going to get an initial coating that could provide instant relief. And then, as the hyaluronic acid builds up in the tissues, it'll be able to bind more and more moisture," says Komorowski. This explains why some women see great results with using it over time.
“Hyaluronic acid works by holding onto water to replenish and maintain moisture. In clinical studies, hyaluronic acid was shown to help maintain a normal acidic pH, maintain the normal cellular architecture seen with estrogen,3 and relieve symptoms associated with vaginal atrophy of menopause,” adds Dr. Dweck.
Potential Risks or Side Effects
Hyaluronic acid is generally very safe and effective for most women, unless you have a known sensitivity. “Hyaluronic acid can be used topically in the vagina and has been extensively researched in clinical studies. It has received FDA clearance. This ingredient is well tolerated and incredibly effective for so many women," says Dr. Dweck. In addition, it's safe for those who don't want to use hormones or can't use them.
What You Need to Know About Revaree and Sex
First, Revaree is not just a sexual lubricant. "A moisturizer such as Revaree can be used regularly as part of a maintenance program to manage and prevent symptoms related to vaginal dryness. A moisturizer is used regardless of sexual activity. A lubricant, in contrast, is typically used on demand during sexual play to facilitate comfort and pleasure," says Dr. Dweck.
Revaree should not be used with condoms. "Revaree is not compatible with natural rubber latex, polyurethane, or polyisoprene condoms. As with many vaginal moisturizers, if Revaree comes into contact with natural rubber latex, polyisoprene, or polyurethane condoms, it may weaken the integrity of the condom. This incompatibility is thought to be due to the glyceride component in Revaree and not the hyaluronic acid itself." says Dr. Dweck.
In terms of safety for a male sexual partner, Dr. Dweck says that Revaree is safe. "Unlike topical estrogen products, Revaree is non-estrogenic and has no known adverse effects for male partners."
- Jokar A, et al. IJCBNM. 2016;4:69-78
- Shuai-Bin, Lui, et al. Gynecological Endocrinology. 2014.10:31:3, 208-213
- Chen J, et al. J Sex Med. 2013;10:1575-1584