A non-hormonal therapy restored vaginal tissue in an animal study, suggesting a possible new treatment for menopause-related GSM.

Genitourinary syndrome of menopause, or GSM, is a chronic condition caused by falling oestrogen levels.

It affects the vulva, vagina and urinary tract, causing symptoms including vaginal dryness, painful sex and recurring vaginal or urinary tract infections.

Steve Nordeen, the study’s senior author and professor emeritus in the department of pathology at the CU Anschutz School of Medicine, said: “For too many women, the current options are either products that only provide temporary relief or hormone-based treatments they may not feel comfortable using.

“Our goal was to develop a therapy that addresses the underlying cause of the vaginal changes that follow menopause, not just the symptoms, without relying on steroid hormones.

“While more research is needed, these findings suggest we may have a promising new approach.”

Researchers at the University of Colorado Anschutz developed the treatment to restore oestrogen signalling only within vaginal tissue, without exposing the rest of the body to the hormone.

In a preclinical animal study, the therapy restored vaginal tissue structure and function lost through oestrogen deficiency.

The results suggest it could address the underlying cause of GSM rather than offer only temporary relief from symptoms.

An estimated 50 to 70 per cent of women experiencing natural or medically induced menopause develop one or more symptoms of GSM.

Women may have to choose between living with painful symptoms, using over-the-counter products with limited effectiveness or taking hormone-based treatments that replace oestrogen.

Some women cannot or choose not to use hormone therapy because of concerns about potential risks. This is particularly relevant to those with a history of breast cancer or an increased risk of hormone-sensitive cancers.

The researchers synthesised a novel non-steroidal oestrogen-signalling molecule called 3-fluoro 6,4′-dihydroxyflavone, or 3F.

Delivered as a vaginal suppository, the therapy regenerated the vaginal epithelium in a preclinical model of menopause. The epithelium is the layer of cells lining the vagina.

Researchers found no evidence of systemic oestrogenic activity, meaning the treatment did not appear to trigger oestrogen responses elsewhere in the body.

The team is seeking support to move the treatment into human clinical trials.

Nordeen said: “Our findings suggest the prospect of a safer and more effective therapy is within reach.

“The next step is securing the support needed to move this therapy into human clinical trials so we can determine whether it offers women a new treatment option.”

The researchers said the therapy could provide a new option for millions of women with GSM if future clinical trials confirm the findings.

IVF success declines with age even when women use young donor eggs, with a marked fall from around 49, research suggests.

The findings challenge the idea that donor eggs can fully “reset” the reproductive clock, although researchers said they should not discourage older couples from trying.

Dr Beatrice Crestani, from an assisted reproduction medical institute in Italy, said reproductive ageing had traditionally been seen mainly as an issue involving the ovaries.

She said replacing older eggs with younger donor eggs was often believed to “reset” the reproductive clock.

Dr Crestani added: “Our findings suggest the picture is more complex.”

The study followed 1,774 women undergoing in vitro fertilisation, or IVF, using donated eggs. IVF involves fertilising an egg in a laboratory before transferring an embryo to the womb.

Women in their mid to late 30s had a 54 per cent chance of becoming pregnant after treatment, compared with around 43 per cent among those aged 49 or older.

Live birth rates fell from 46 per cent to 32 per cent, while miscarriage rates rose from 24 per cent to 38 per cent.

Women aged 49 and older had twice the risk of miscarriage compared with those aged 35 to 40.

Researchers believe changes to the endometrium with age may help explain the difference. The endometrium is the lining of the womb where a fertilised egg or embryo implants and grows.

Although the thickness of the womb lining was similar across the age groups, its condition declined with age.

Researchers said future work might find ways to predict, prevent or improve uterine ageing.

Dr Crestani said: “These findings should not discourage women from pursuing donor-egg treatment, because success rates remain meaningful even at advanced ages.

“However, patients should be counselled that donor eggs cannot completely eliminate the effects of reproductive ageing, particularly beyond 49 years.”

Among women who transferred all their available embryos, the live birth rate was around 80 per cent for those aged 35 to 40 and 62.5 per cent for those aged 49 or older.

Experts stressed that the health of the womb and ovaries differs between women.

There is no legal upper age limit for IVF in the UK, unlike some European countries. Greece has an upper limit of 54.

Women in the UK can donate or share their eggs up to the age of 36.

Regulators ask private UK clinics to assess the welfare of any resulting child and whether the recipient can safely carry a pregnancy.

NHS guidelines recommend offering three IVF cycles to women up to the age of 40 and one cycle to women up to the age of 42.

Patients using donor eggs usually have to fund that part of the treatment themselves.

People conceived using sperm, eggs or embryos from donors registered after 1 April 2005 can request identifying information about their biological donor parent once they turn 18.

The findings are being presented at the European Society of Human Reproduction and Embryology.

Professor Borut Kovacic, chair-elect of the society, said researchers were trying to better understand the “cross-talk” between an implanting embryo and the womb lining. This refers to the biological signals exchanged during implantation.

He said the age threshold associated with the beginning of a loss of uterine function was unlikely to be absolute.

Professor Kovacic added: “It provides important information for patients and offers a valuable foundation for future research aimed at identifying novel biomarkers of uterine ageing.”

Dr Ippokratis Sarris, chair-elect of the British Fertility Society, called for more research.

He said pregnancies could carry greater risks for older women and recommended thorough health checks and counselling for couples beginning fertility treatment.

Two endometriosis tests could cut years from diagnosis after NICE backed their temporary NHS use in England and Wales.

EndoSure and Endotest have been recommended in draft guidance, with one able to provide results in 45 minutes.

Endometriosis affects around one in 10 women of reproductive age. It occurs when tissue similar to the womb lining grows elsewhere, including around the ovaries and fallopian tubes.

Symptoms can include painful periods, painful bowel movements, pain when urinating and pain during or after sex.

Diagnosis can involve ultrasound scans, magnetic resonance imaging (MRI) or laparoscopy. A laparoscopy is keyhole surgery in which a camera is inserted through a small cut in the abdomen.

Despite the effect the condition can have on physical and mental health, women can wait years for a diagnosis.

The average wait in the UK is nine years and four months, rising to 11 years for women from ethnically diverse communities, according to the National Institute for Health and Care Excellence (NICE).

Long waits can increase suffering, prolong poor health and allow the condition to progress, making it more difficult to treat.

Dr Anastasia Chalkidou, NICE’s healthtech programme director, said: “A diagnosis of endometriosis can for some women take the best part of a decade, with the UK average standing at nine years and four months, and rising to 11 years for those from ethnically diverse communities.”

She said delays could lead to chronic pain affecting daily life, relationships and work.

She added: “These technologies have the potential to change that by giving primary care professionals better non-invasive tools to identify endometriosis earlier, allowing earlier and better treatment.

“Our draft guidance reflects our commitment to getting promising innovations to patients quickly, while making sure the evidence to support their wider use is built in a rigorous way.”

Endotest examines a saliva sample for microRNAs, tiny biological markers that can indicate the presence of endometriosis.

The sample is sent to a laboratory and the result returned to a GP or another healthcare professional to inform the next steps in diagnosis and care.

EndoSure uses sensor pads placed on the abdomen to measure electrical signals in the gut.

Women must fast for between six and eight hours before the 45-minute test. During the procedure, they drink water until they feel full, helping the device record gut activity accurately.

Results are available as soon as the test is complete.

The draft recommendation, published on Tuesday, approves both technologies for three years while further evidence is collected on how well they work.

NICE will then decide whether to approve them permanently for NHS use.

NICE said a third test, DotEndo, needs more research before it can be recommended.

EndoSure and Endotest are not designed to diagnose the condition on their own.

They are intended for women whose symptoms still suggest endometriosis after a normal clinical examination and negative or inconclusive imaging results, or when imaging has not been carried out.

Dr Gail Busby, a consultant gynaecologist at Manchester University NHS Foundation Trust, said: “These tests are a gamechanger because they give us answers much earlier, without the need for invasive surgery, and that means we can start the right treatment sooner.

“An earlier diagnosis doesn’t just change one person’s life, it frees up appointments and surgical slots for everyone waiting for care.”

Emma Cox, of Endometriosis UK, welcomed the tests.

She said their introduction should be supported by education for GPs and nurses to ensure prompt access and prevent symptoms from going unrecognised.