Provoked Vestibulodynia Clinical Trial
Provoked vestibulodynia, previously called vulvar vestibulitis syndrome, is clinically
defined as chronic, unexplained, vulvar pain or discomfort confined to the vulvar vestibule
in response to contact or pressure. In addition, many patients also have pain in response to
non-sexual activities such as tampon insertion, gynecological examinations or physical
pursuits such as bicycle riding; the severity of other vulvo-vaginal symptoms such as
itching, burning and irritation varies. Once women with provoked vestibulodynia develop the
syndrome, symptoms may last for months or years; as a result, provoked vestibulodynia has a
profound effect on women's sexuality and psychological well-being. The diagnosis of provoked
vestibulodynia is usually made by ascertaining if the patient fulfills modified Friedrich's
criteria, consisting of 1) a history of vulvar pain, dyspareunia or pain with tampon
insertion, 2) tenderness of the vestibule when being touched with a cotton-tip applicator
and 3) no identifiable cause for the pain.
The etiology of this condition remains unknown. Proposed causes include chronic
inflammation, peripheral neuropathy, genetic, immunologic and hormonal factors, infectious,
psychological disorders, sexual dysfunction or disturbance in the central nervous system.
Because the cause of provoked vestibulodynia remains unknown, many different treatments have
been described for this condition, including topical and intra-lesional corticosteroids,
topical anesthetics such as lidocaine, topical estrogen, topical or oral antidepressants or
anti-convulsants, biofeedback or physical therapy, surgical resection of the involved tissue
(vestibulectomy) and a variety of complementary and alternative therapies.
Low level laser therapy (LLLT) is an emerging medical technique in which exposure to
low-level laser light or light emitting diodes might stimulate or inhibit cellular function,
possibly leading to beneficial clinical effects. Clinical applications that show some
potential of effectiveness include treating soft tissue injury, chronic pain, and wound
healing. The usage of low level laser therapy was found effective in various pain syndromes,
and has no side effects.
Since inflammatory mechanisms have been proposed in the pathogenesis of provoked
vestibulodynia, and as there is no effective therapy for this syndrome, the investigators
intend to study whether low level laser therapy might be an effective therapy for provoked
vestibulodynia.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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Investigating the Effectiveness of PelvicSense(R) on Pain and Sexual Outcomes in Provoked Vestibulodynia
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Is Low Level Laser Therapy (LLLT) Effective for Reducing Pain Experienced by Women With Provoked Vestibulodynia?
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