Capsaicin for the treatment of vulvar vestibulitis

Steinberg, Adam C.; Oyama, Ian A.; Rejba, Amy E.; Kellogg‐Spadt, Susan; Whitmore, Kristene

doi:10.1016/j.ajog.2004.10.626

Cited by 92 publications

(49 citation statements)

References 10 publications

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“…Given this disease probably has the same etiopathogenesis as fibromyalgia, therapy is multifactorial and based on pharmaco- logical and non-pharmacological strategies and compliance with adequate standards of hygiene and behavior. The pharmacological strategies include topical preparations, such as local anesthetics and/or the submucosal infiltration of local anesthetics associated with steroids (triamcinolone and local anesthetics); drugs that act on the pain mediator, such as tricyclic antidepressants, anticonvulsants, selective serotonin reuptake inhibitors and selective serotonin and noradrenalin reuptake inhibitors (15)(16)(17)(18)(19). The non-pharmacological strategies are represented by rehabilitation of the pelvic floor muscles and/or biofeedback techniques involving particularly the levator ani, transcutaneous electrical nerve stimulator, vaginal dilators, and cognitivebehavioral therapy (20)(21)(22).…”

Section: Vulvodyniamentioning

confidence: 99%

Chronic pelvic pain: comorbidity between chronic musculoskeletal pain and vulvodynia

et al. 2014

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summary Chronic pelvic pain (CPP) is a common condition that has a major impact on the quality of life of both men and women. Male CPP is usually attributable to well-defined urogenital conditions (most frequently infectious/non infectious prostatic diseases) or musculoskeletal or bowel diseases, whereas the features of female CPP are much more complex and are of particular clinical and epidemiological importance. It is a multifactorial syndrome that can be due to diseases of the urogenital, gastrointestinal, or musculoskeletal systems, or to neurological or neuropsychiatric disorders. It is not always easy to identify its predominant pathogenesis, although it often occurs as a central sensitization syndrome triggered by an initial stimulus which is no longer detectable and only manifests itself clinically through pain. In this respect, there are some very interesting relationships between vulvodynia and fibromyalgic syndrome, as identified in a preliminary study of women with chronic musculoskeletal pain in which it was demonstrated that vulvar pain plays an important role, although it is often overlooked and undiagnosed.

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Section: Vulvodyniamentioning

confidence: 99%

Chronic pelvic pain: comorbidity between chronic musculoskeletal pain and vulvodynia

et al. 2014

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“…However, they have been found to be minimally efficacious, with one study demonstrating only a 20% improvement in pain scores which was not significantly different from placebo [24]. Capsaicin, conversely, decreased pain with intercourse by 95% in one study, though the residual burning sensation was not tolerable as a side effect for many women [8,25]. Botulinum Toxin Type A (Botox) acts at nociceptors to cause local muscle paralysis of 3-6 month duration, making it an appropriate choice for women who have difficulties with pelvic floor hyperactivity causing pain.…”

Section: Treatmentmentioning

confidence: 98%

Genito-Pelvic Pain/Penetration Disorder (GPPPD): An Overview of Current Terminology, Etiology, and Treatment

Conforti

2017

UOJM

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Genito-Pelvic Pain/Penetration Disorder (GPPPD) is a relatively new diagnostic category of female sexual dysfunction, which was introduced during the release of the DSM-5 in 2013. GPPPD reflects the combination of two previous categories of female sexual dysfunction, dyspareunia and vaginismus, into one entity. As such, there is confusion surrounding the proper terminology and diagnostic criteria used when evaluating female sexual or genital pain. This review article attempts to clarify the terminologies used within the medical and scientific community, and provides an overview of current views on etiology and treatment. The likely biological antecedents to genital pain are an exaggerated and prolonged inflammatory response in the vestibular mucosa causing neuroproliferation, and leading to eventual hyperalgesia, allodynia, and pelvic muscle tension in the genital region. These processes interact with psychosocial factors to produce chronic pain. Treatment includes education, CBT, pelvic floor physiotherapy, medical interventions, and surgical interventions, though sexual function may be optimized through a multifaceted approach. RésuméLa GPPPD est une catégorie diagnostique relativement récente de la dysfonction sexuelle féminine, qui a été introduite dans le DSM-5 en 2013. La GPPPD reflète la combinaison de deux catégories précédentes de dysfonctionnement sexuel féminin, la dyspareunie et le vaginisme, en une entité. En tant que tel, il existe une confusion entourant la terminologie appropriée et les critères de diagnostique utilisés lors de l’évaluation de la douleur sexuelle ou génitale féminine. Cet article de revue tente de clarifier les terminologies utilisées dans la communauté médicale et scientifique et donne un aperçu des points de vue actuels sur l’étiologie et le traitement. Les antécédents biologiques probables à la douleur génitale sont une réponse inflammatoire exagérée et prolongée dans la muqueuse vestibulaire entraînant une neuroprolifération, et conduisant à une éventuelle hyperalgésie, allodynie et tension musculaire pelvienne dans la région génitale. Ces processus interagissent avec des facteurs psychosociaux pour produire une dou- leur chronique. Le traitement comprend l’éducation, la TCC, la physiothérapie du plancher pelvien, les interventions médicales et les interventions chirurgicales, bien que la fonction sexuelle puisse être optimisée par une approche multidimensionnelle.

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“…Many topical medications have been used anecdotally or shown to be effective in small studies or case series. These include 2-6 % gabapentin formulation [ 36 ], compounded topical estradiol 0.03 % with testosterone 0.1 % [ 37 ], capsaicin [ 38 ], amitriptyline 2 % cream (sometimes combined with baclofen 2 %) [ 39 ], or nifedipine cream [ 40 ]. None of these treatments are evidence based, and all of these treatments are off-label for the treatment of vulvodynia.…”

Section: Topical Medicationsmentioning

confidence: 99%