Abstract
Objective
To describe patient characteristics of women diagnosed with generalized unprovoked
vulvodynia (GUV) and to estimate efficacy and tolerability of treatment.
Material and methods
Retrospective observational study in 241 women who presented with GUV at three vulvar
disease clinics in Rotterdam, The Netherlands during 1996–2013. Main outcome was efficacy
of amitriptyline, gabapentin or pregabalin treatment.
Results
The median duration of symptoms was 24 months and median age 62 years (range 36–89).
Most of the patients reported a burning sensation, often worsened by sitting, urinating
or having intercourse. Treatment with either amitriptyline, gabapentin or pregabalin
produced long lasting pain relief in 60% and temporary pain relief in 10%, while treatment
was not successful in 30% of the patients. Around 30% of the patients had to stop
their medication due to side effects.
In 44 of the 241 (18%) women signs of vulvar dermatoses were present that could not
explain the symptoms. These women experienced the same therapeutic efficacy as those
without any visible abnormalities (chi-square goodness of fit p = 0.49).
Conclusions
Amitriptyline, gabapentin and pregabalin produced long lasting pain relief in most
of the women with GUV. The 2015 International Society for the Study of Vulvovaginal
Disease nomenclature acknowledges the concomitant presence of vulvar dermatoses and
vulvodynia. This enables treatment of both conditions simultaneously, a situation
that occurs regularly according to our study. We advocate that women with symptoms
of GUV, with or without the presence of vulvar dermatoses, receive a therapeutic trial
with drugs such as amitriptyline.
Keywords
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Article info
Publication history
Published online: October 31, 2017
Accepted:
October 30,
2017
Received in revised form:
September 28,
2017
Received:
July 6,
2017
Identification
Copyright
© 2017 Published by Elsevier Ireland Ltd.
