Evaluation and Treatment of Vulvodynia: State of the Science.
Judith M Schlaeger, Jennifer E Glayzer, Michelle Villegas-Downs and 8 others
PMID 36533637WHAT IT FOUND
Pelvic floor physical therapy reduced pain during intercourse more than overnight lidocaine in a randomized trial.
Many other vulvodynia treatments showed no difference from placebo, so evidence is weak. Start with the least invasive treatments.
Key findings
01In a randomized trial of 212 women, multimodal physical therapy reduced pain during intercourse more than lidocaine.
02The review included 41 studies, and most vulvodynia studies lack controls, small samples, and direct comparisons.
03Vaginal diazepam did not improve pelvic pain more than placebo.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
The authors say most studies lack control groups, have small samples, and do not compare treatments with each other. Pain and intercourse pain measures are not standardized across studies. Positive results often come from before-and-after comparisons without placebo controls.
Declared interests
No conflicts-of-interest or funding declaration appears in the supplied text. The publication types list NIH extramural research support.
The easy way to misread this
Do not read the physical therapy finding as proof that vulvodynia treatments work. Most studies were small, uncontrolled, or did not beat placebo, so choose least invasive treatments and track pain.