Concomitant Treatment with Topical Hyaluronic Acid and High Concentration Oxygen Therapy (Vaginal Natural Oxygenation Device - VNOD) in the Improvement of Symptoms Related to Genitourinary Syndrome of Menopause in Women with Natural and Oncological Postmenopause: Open-Label, Single-Center, Randomize

Inclusion Criteria:

• Informed consent signature

• Willingness to undergo treatment and follow-up evaluations according to the scheduleoutlined in the protocol

• Age > 18 years

Cohort 1:

• Diagnosis of non-metastatic breast cancer (M0/Mx according to TNM system) who haveundergone surgical and/or chemotherapy and/or immunotherapy and/or radiotherapyand/or endocrine treatment.

• Postmenopausal women (FSH > 30 UIIU/L, E2 < 20 pg/ml), either naturally orsurgically induced, or iatrogenic post-chemotherapy with absent menstrual cycle forat least 6 months; or premenopausal women on treatment with LHRH analog +/-tamoxifen and/or aromatase inhibitor for at least 6 months.

• At least a score of 2 (moderate) for vaginal dryness associated with vulvovaginalatrophy (score 2-3 on the MBS scale).

• Signs of pelvic static alterations not exceeding POP-Q score 2 (POP-Q).

Cohort 2:

• Postmenopausal women (FSH > 30 UI/L, E2 < 20 pg/ml), with absent menstrual cycle forat least 6 months, or women who have undergone bilateral adnexectomy at least 6months ago.

• At least a score of 2 (moderate) for vaginal dryness associated with vulvovaginalatrophy (score 2-3 on the MBS scale).

• Signs of pelvic static alterations not exceeding POP-Q score 2 (POP-Q).

Exclusion Criteria:

• Other current therapy aimed at resolving symptoms associated with vulvo-vaginalatrophy, with the exception of the use of lubricants if sexual activity is present;

• HRT in progress or discontinued for less than 6 months;

• Ongoing vulvo-vaginal and urinary infections;

• Bleeding of ndd;

• Pathological pap-test within the previous 12 months.