Cervical preparation for office hysteroscopy in peri- and post-menopause

A prospective cohort study involved women aged 45-90 years subjected to office hysteroscopy. Women were assigned to three study arms: A) 0.5 mg of estriol in vaginal cream twice daily for 10 days pre-procedure, B) 5 mg of hyaluronic acid in vaginal gel twice daily for 10 days pre-procedure, C) no medication. The following endpoints were compared: pain accompanying the procedure, need for cervical dilation, time of cervical passage, incidence of severe urogenital atrophy and vaso-vagal reaction.