Capsaicin and the Treatment of Vulvar Vestibulitis Syndrome: A Valuable Alternative?

Filippo Murina, MD, Gianluigi Radici, MD, and Vanda Bianco, MD

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Results

Thirty-two women completed the therapy protocol. One patient abandoned the therapy after using capsaicin cream for 5 days due to intense burning. In 19 patients (59%), improvement of symptoms was recorded ( Table 1 ), but none reported complete remission. In these women, a mean 100-mm visual analogue scale was 67.3 before treatment and 15.8 after 8 weeks; whereas dyspareunia ranged from a baseline score of 2.7 to 1.0 after 8 weeks of treatment. Symptoms recurred in all of the patients an average of 15 days after they had stopped using the capsaicin cream. Symptoms improved again about 20 days after the twice-weekly topical application of capsaicin was resumed. Thirteen patients (41%) didn't show improvement of any kind despite using capsaicin for 2 months. According to baseline symptom scores, factors such as age, duration of disease, use of oral contraceptive, and primary vs secondary VVS, there was no significant difference between women who had pain reduction compared with those who did not.

Burning was reported as the only side effect, but it was reported as severe by all of the patients. It occurred 20 to 30 minutes post application, in spite of pretreatment with anesthetic cream; it abated 40 to 60 minutes later, and decreased at each subsequent application in the majority of patients. In 1 case, it was so severe that the patient abandoned treatment. No systemic effects were observed.

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