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Drugs

, Volume 79, Issue 5, pp 483–493 | Cite as

Treatment of Vulvodynia: Pharmacological and Non-Pharmacological Approaches

  • Natalie O. RosenEmail author
  • Samantha J. Dawson
  • Melissa Brooks
  • Susan Kellogg-Spadt
Leading Article

Abstract

Vulvodynia is a common, recurrent, vulvar pain condition with debilitating consequences for affected women’s health and quality of life. The heterogeneity of women suffering from vulvodynia as well as its uncertain and likely multifactorial etiology pose a significant challenge to identifying any kind of “gold standard” treatment. Thus, treatment providers must be well versed in the various options and the evidence for each. In this review, we begin with pharmacological treatments, followed by non-pharmacological treatments, surgery, and finally multimodal treatments. For each approach, we briefly discuss the method, mechanism of action, and empirical support for the treatment. In sum, pharmacological treatments that may be beneficial but require further research include antinociceptive agents (lidocaine, capsaicin), anti-inflammatory agents (corticosteroids, interferon), neuromodulating medications (anticonvulsants and antidepressants), hormonal agents, and muscle relaxants (e.g., botulinum toxin). There is strong evidence to support and recommend non-pharmacological interventions including psychological therapy, pelvic floor physical therapy, as well as surgery (i.e., vestibulectomy for provoked vestibulodynia) for the treatment of vulvodynia. We conclude this review with a discussion of issues that may have hindered progress of treatment efficacy and effectiveness, and recommendations for moving the field forward.

Notes

Compliance with Ethical Standards

Funding

In the preparation of this article, N. O. Rosen was supported by a New Investigator Salary Award from the Canadian Institutes of Health Research (CIHR).

Conflict of interest

Natalie O. Rosen, Samantha J. Dawson, Melissa Brooks, and Susan Kellogg-Spadt have no conflicts of interests.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Psychology and NeuroscienceDalhousie UniversityHalifaxCanada
  2. 2.Department of Obstetrics and GynaecologyDalhousie UniversityHalifaxCanada
  3. 3.Department of Obstetrics and GynaecologyDrexel University College of MedicinePhiladelphiaUSA
  4. 4.Center for Pelvic MedicineBryn MawrUSA
  5. 5.Departments of Psychology and NeuroscienceDalhousie UniversityHalifaxCanada

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