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Vulvodynia: A Common and Under-Recognized Pain Disorder in Women and Female Adolescents -- Integrating Current Knowledge into Clinical Practice
*Patient recommendations for vulvar self-care can be viewed at: http://www.nva.org/tips.
^Detailed dosing and side effect information/charts for oral (and topical) medications used to treat vulvodynia are contained in The Vulvodynia Guideline, which can be viewed/downloaded at: www.nva.org/haefner.
** In the medical literature, only two randomized controlled trials have evaluated the efficacy of oral tricyclic antidepressants. Neither randomized controlled trial found positive results, i.e., the treatment provided only minimal relief of vulvar pain. These studies, however, included women with localized and generalized vulvodynia, as well as women with provoked and unprovoked vulvodynia, so treatment efficacy for specific subgroups is unknown.
Despite their widespread use, even less efficacy data is available on anticonvulsants than on tricyclic antidepressants, with only three retrospective case series conducted to date. Even though these studies reported positive findings, there were no control groups. The first randomized controlled trial evaluating gabapentin for treatment of vulvodynia is ongoing (Brown CS, Foster DC, Bachmann GA. A Controlled Trial of Gabapentin in Vulvodynia: Biological Correlates of Response). See the following website for more information, https://clinicaltrials.gov/show/NCT01301001.