Bazin Sylvie, Lefebvre Jessica, Fortier Michel, Brisson Jacques, Brouillette François, Bujold Emmanuel, Bouchard Céline
Service d'obstétrique-gynécologie, Centre hospitalier universitaire de Québec (Québec); Département d'obstétrique-gynécologie, Faculté de médecine, Université Laval (Québec).
Département de médecine sociale et préventive, Faculté de médecine, Université Laval (Québec).
J Obstet Gynaecol Can. 2011 Aug;33(8):838-843. doi: 10.1016/S1701-2163(16)34987-8.
Our objective was to assess the short-term effect of an estrogen cream on symptoms associated with provoked vestibulodynia.
We undertook a double-blind randomized trial in women who had experienced dyspareunia satisfying the Friedrichcriteria for at least three months. We compared the daily application of 3 g of vaginal cream containing 1.875 g of conjugated estrogens for six weeks (estrogen group) with the application of a comparable cream without estrogens (placebo group). The main outcome was modification of dyspareunia,determined by a visual analogue scale of pain from the pretreatment period to the post-treatment period. Secondary outcomes were colposcopic evaluation of the vulva and pain reported during the swab test.
Of 69 women randomized, 61 participated for the full duration of the trial. Dyspareunia was significantly lessened in both groups (estrogen group: 7.4 ± 1.9 pre-treatment vs. 4.8 ± 3.0 post-treatment, P < 0. 01; placebo group:7.1 ± 1.9 vs. 4.9 ± 2. 7, P < 0.01), but the difference observed in terms of decrease between the two groups was not found to be significant (P = 0.5). Alternatively, the group treated with estrogen cream showed (1) a more substantial decrease of the pain reported at the orifices of the Bartholin’s glands when palpated with a swab (P < 0.01), and (2) a decrease of the inflammation observed at the orifices of the Bartholin’s glands orifices and the posterior fourchette (P < 0.01).
Applying a vaginal cream, whether it contains estrogens or not, for six weeks lessens dyspareunia. Adding estrogens to such a cream could facilitate a decrease of the inflammation observed at the orifices of the Bartholin’s glands and the vestibule.
我们的目的是评估雌激素乳膏对激发性前庭痛相关症状的短期影响。
我们对符合弗里德里希标准至少三个月的性交困难女性进行了一项双盲随机试验。我们将每天涂抹含1.875 g结合雌激素的3 g阴道乳膏六周（雌激素组）与涂抹不含雌激素的类似乳膏（安慰剂组）进行了比较。主要结局是性交困难的改善，通过从治疗前期到治疗后期的疼痛视觉模拟量表来确定。次要结局是对外阴的阴道镜评估以及拭子试验期间报告的疼痛。
在69名随机分组的女性中，61名完成了整个试验过程。两组的性交困难均显著减轻（雌激素组：治疗前7.4±1.9，治疗后4.8±3.0，P<0.01；安慰剂组：7.1±1.9 vs. 4.9±2.7，P<0.01），但两组之间观察到的减轻差异不显著（P = 0.5）。另外，用雌激素乳膏治疗的组显示：（1）用拭子触诊时，巴氏腺开口处报告的疼痛有更显著的减轻（P<0.01），以及（2）巴氏腺开口和后阴唇系带处观察到的炎症减轻（P<0.01）。
涂抹阴道乳膏六周可减轻性交困难，无论该乳膏是否含有雌激素。在这种乳膏中添加雌激素可促进巴氏腺开口和前庭处观察到的炎症减轻。
