CASE REPORT   

Minerva Obstetrics and Gynecology 2022 June;74(3):302-7

DOI: 10.23736/S2724-606X.22.04894-1

Copyright © 2022 EDIZIONI MINERVA MEDICA

lingua: Inglese

Behavioral sex therapy and medications associated in the treatment of provoked vulvodynia: efficacy on pain and sexuality in three illustrative cases

Anna GHIZZANI, Giulia TOTO, Stefano LUISI ✉

Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, Le Scotte Polyclinic, University of Siena, Siena, Italy

This paper tests the hypothesis that medications combined with behavioral sex therapy might lessen pain and restore sexuality in women with provoked vulvodynia. Three women affected by vulvodynia, otherwise healthy, in heterosexual relationship were treated at the Department of Obstetrics and Gynecology in a university hospital. In consecutive sessions of behavioral sex therapy, oral tricyclic antidepressants and vulvar applications of estrogen and hydrocortisone creams were prescribed in association with vaginal dilators and sensate focus exercises. The outcome supports the hypothesis that combined medications and sexual behavior interventions may be effective in lessening pain and restoring sexuality in women with provoked vulvodynia. The different dyadic balances observed in this small case series suggest how to best use this protocol. The positive results appear to be mostly due to behavioral sex therapy that was the new element added to the combination of pharmacological agents commonly used to treat provoked vulvodynia.

KEY WORDS: Vulvodynia; Pharmaceutical preparations; Therapeutics; Behavior therapy; Dyspareunia