Status:

COMPLETED

Vestibulodynia: Understanding Pathophysiology and Determining Appropriate Treatments

Lead Sponsor:

Duke University

Collaborating Sponsors:

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Conditions:

Vestibulodynia

Temporomandibular Disorder

Eligibility:

FEMALE

18-50 years

Phase:

PHASE2

Brief Summary

Vestibulodynia (VBD) is a complex chronic vulvar pain condition that impairs the psychological, physical, and sexual health of 1 in 6 reproductive aged women in the United States. Here, the investigat...

Detailed Description

Vestibulodynia (VBD) is a chronic pelvic pain condition that affects 1 in 6 reproductive aged women, yet remains ineffectively treated by standard trial-and-error approaches. The investigators have id...

Eligibility Criteria

Inclusion

  • Inclusion Criteria
  • Female
  • Age 18-50 years
  • English-literate
  • Willingness to provide informed consent
  • Meeting criteria for diagnosis of VBD based on:
  • self-report of 3 continuous months of insertional (entryway) dyspareunia, and/or pain to touch/tampon insertion
  • pain score of ≥ 3 on the tampon insertion test
  • Exclusion Criteria
  • Use of daily topical lidocaine, or estradiol, or lidocaine/estradiol to the vulvar vestibule within the past three months
  • Use of nortriptyline or other TCA medications within the past three months
  • Use of pregabalin or gabapentin within the past three months
  • Presence of active dermatologic vulvar disease or vaginal infection
  • Untreated atrophic vaginitis (participants may undergo treatment and re-evaluation for enrollment if the condition is resolved)
  • Previous vestibulectomy
  • Pregnant or planning on becoming pregnant during the study period. Within the first six months of the postpartum period. Currently breastfeeding/lactating, or within three months of discontinuing breastfeeding/lactation.
  • Active incarceration
  • Cancer within the past year.
  • Chemotherapy and/or radiation treatment within the past year.
  • Unstable medical condition (e.g., renal impairment, significant hematological disease, cardiovascular disease, hepatic insufficiency, neurological disorder, autoimmune disease, or respiratory illness)
  • Clear inflammatory states (e.g., morbid obesity)
  • Use of immunosuppressant medications
  • History of intolerance to nortriptyline, topical lidocaine, or topical estradiol
  • Contraindications to use of nortriptyline: current use, or use within the past 3 months, of MAOIs, SSRIs, SNRIs, NDRIs; recent (within the past year) myocardial infarction, active psychotic or suicidal thoughts, narrow angle closure glaucoma
  • Contraindications to the use of lidocaine or local anesthetics
  • Contraindications to the use of topical estrogen therapy
  • Post-menopausal, defined as no menses for 12 consecutive months or surgical removal of both ovaries. (Hysterectomy is not an exclusion)
  • Have not had Botox of the pelvic floor muscles in the last 12 months, or pelvic nerve blocks in the last three months.
  • Are not currently enrolled or planning to enroll in another clinical trial during the course of this trial.
  • Are not currently receiving pelvic physical therapy

Exclusion

    Key Trial Info

    Start Date :

    November 4 2019

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    May 30 2024

    Estimated Enrollment :

    223 Patients enrolled

    Trial Details

    Trial ID

    NCT03844412

    Start Date

    November 4 2019

    End Date

    May 30 2024

    Last Update

    June 7 2024

    Active Locations (2)

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    Page 1 of 1 (2 locations)

    1

    University of California, Los Angeles

    Los Angeles, California, United States, 90095

    2

    University of North Carolina at Chapel Hill

    Chapel Hill, North Carolina, United States, 27278