Topical nifedipine for the treatment of localized provoked vulvodynia: A placebo-controlled study

Jacob Bornstein, Ruba Tuma, Yaniv Farajun, Audrey Azran, Doron Zarfati

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Topical application of the calcium antagonist nifedipine has demonstrated effectiveness in treating chronic anal fissure, without adverse effects. Like chronic anal fissure, vulvodynia is associated with muscle hypertonicity and an inflammatory infiltrate. We conducted a double-blind placebo-controlled study to investigate the effectiveness of 2 concentrations of topical nifedipine cream in the treatment of vulvodynia. Thirty participants were alternately assigned to 3 topical treatment groups: .2% nifedipine, .4% nifedipine, and placebo. All administered the cream to the vestibule 4 times daily for 6 weeks. For all 3 treatment groups, mean pain intensity on vestibular touch, assessed by the Q-tipped cotton test, pain from speculum insertion, and reports of pain during sexual intercourse was reduced at post-treatment compared with pre-treatment. These improvements remained at 3 months' follow-up. The effectiveness of nifedipine in treating vulvodynia did not exceed that of placebo. Perspective: The topical application of both nifedipine and a placebo reduced pain in women with vulvodynia. This study highlights the need for controlled trials of treatments for vulvodynia and raises doubts about studies conducted without comparison to placebo.

Original languageEnglish
Pages (from-to)1403-1409
Number of pages7
JournalJournal of Pain
Volume11
Issue number12
DOIs
StatePublished - Dec 2010
Externally publishedYes

Bibliographical note

Funding Information:
Supported by the Department of Obstetrics and Gynecology of Western Galilee Hospital-Nahariya .

Keywords

  • Chronic anal fissure
  • Localized provoked vulvodynia
  • Nifedipine
  • Physical therapy
  • Vulvodynia

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