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Archive for the ‘Vulvodynia’ Category

Our clinical trial protocol has been published recently in Journal of Integrative Medicine, the PDF of whole article is available based on request.

Effectiveness of two different acupuncture strategies in patients with vulvodynia: Study protocol for a pilot pragmatic controlled trial.

Fan AY, Alemi SF, Zhu YH, Rahimi S, Wei H, Tian H, He D, Gong C, Yang G, He C, Ouyang H.  J Integr Med. 2018 Oct 10. pii: S2095-4964(18)30103-1. doi: 10.1016/j.joim.2018.10.004. [Epub ahead of print]

Abstract

BACKGROUND:

Vulvodynia, or vulvar pain, is a common condition in women; however, there are few evidence-based clinical trials evaluating nonpharmacological therapies for this condition. Acupuncture is one complementary and integrative medicine therapy used by some patients with vulvodynia. This study evaluates two different acupuncture strategies for the treatment of vulvodynia and aims to evaluate whether either of the acupuncture protocols reduces vulvar pain, pain duration or pain with intercourse. The study also examines how long the effect of acupuncture lasts in women with vulvodynia.

METHODS/DESIGN:

The study is designed as a randomized controlled trial, focused on two acupuncture protocols. Fifty-one patients who have had vulvodynia for more than 3 months will be recruited. Among them, 34 patients will be randomized into Groups 1a and 1b; those who are unwilling to receive acupuncture will be recruited into the standard care group (Group 2). Patients in Group 1a will have acupuncture focused on the points in the pudendal nerve distribution area, while patients in Group 1b will receive acupuncture focused on traditional (distal) meridian points. Patients in Group 2 will receive routine conventional treatments, such as using pain medications, local injections and physical therapies or other nonsurgical procedures. Acupuncture will last 45 min per session, once or twice a week for 6 weeks. The primary outcome measurement will be objective pain intensity, using the cotton swab test. The secondary outcome measurement will be subjective patient self-reported pain intensity, which will be conducted before cotton swab test. Pain intensities will be measured by an 11-point Numeric Pain Rating Scale. Pain duration and pain score during intercourse are recorded. Local muscle tension, tenderness and trigger points (Ashi points) are also recorded. All measurements will be recorded at baseline (before the treatment), at the end of each week during treatment and at the end of the 6 weeks. Follow-up will be done 6 weeks following the last treatment.

DISCUSSION:

Results of this trial will provide preliminary data on whether acupuncture provides better outcomes than nonacupuncture treatments, i.e., standard care, and whether acupuncture focused on the points in pudendal nerve distribution, near the pain area, has better results than traditional acupuncture focused on distal meridian points for vulvodynia.

TRIAL REGISTRATION:

Clinicaltrials.gov: NCT03481621. Register: March 29, 2018.

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http://acupuncture.blog.co.uk/2009/11/25/can-acupuncture-help-vulvodynia-sex-with-unbearable-pain-7457496/ 

by Acupuncturist Pro @ 2009-11-25 – 15:34:31

vulvodynia (vulval pain) known as vulvar vestibulitis, which, although it has made perhaps two brief forays into the media in that time, seems generally unknown except to those who suffer from it. Briefly, it has no known definite cause or cure and the symptoms are simply excruciating spots of soreness just inside the entrance to the vagina,vulvodynia was a relatively common condition that affects about 15% of the UK’s female population. The latest study, published in the American Journal of Obstetrics and Gynecology, bolsters that idea.
Researchers found that of nearly 2,300 Michigan women they surveyed, just over eight percent had symptoms of vulvodynia — including pain near the opening of the vagina that had lasted for at least three months.

The prevalence of vulvodynia was similar across age groups, up to the age of 70, the study found. The decline after that age seemed to be related to a dip in women’s sexual activity.

The most common symptom of vulvodynia is pain during sexual intercourse, and the condition was first defined in 1880. It is not determined yet exactly what triggers vulvodynia, but a few theories have been tested and proven to be helpful in properly diagnosing the illness,Vulvodynia is especially difficult to diagnose because there are almost no physical signs of illness or infection and doctors have to rely on patients’ descriptions of the symptoms. vulvodynia is a common condition, but it is often undiagnosed or misdiagnosed.vulvodynia is difficult to diagnose. A diagnosis often occurs only after other conditions are excluded. “Vulvodynia is diagnosed when other causes of vulvar pain, such as yeast or bacterial infections, or skin diseases, are ruled out,” Veasley said. The tissue of the vulva region may appear swollen or inflamed, but more often than not, it looks normal.

The cause of essential vulvodynia is unknown. There is some evidence that damage to the nerves, particularly the pudendal nerve, supplying this area may play a role.

The prognosis without treatment or spontaneous remission may be for unceasing pain, leading to poor quality of life. Rarely, frequency of micturition (urination), stress incontinence, and chronic constipation may also develop.At present there is insufficient evidence to document any benefit from amitriptyline or pudendal nerve decompression for women with essential vulvodynia.

Zak acupuncture continues to push for resources and relief for women experiencing serious pain in the so-called V-spot — the vestibule where the vagina and vulva meet.An estimated 15 per cent of women have experienced the extreme sensitivity and burning related to vestibulodynia.

X, female, 55 years old, low back pain eight months, and there urgency, urethral pain, perineal pain, the clitoris pain, painful sexual intercourse. Clinical examination: straight-leg raising test, normal. Highly sensitive point in both side roots of the thigh, left was serious ,hip flexor knees at a consolidated trial, leads to the roots of the thigh pain, ulna pain, tenderness is extremely sensitive .diagnosis: the roots of bilateral thigh soft tissue damage, clitoris pain.
Treatment: zak acupuncture
Results: After a period of treatment, patient’s genital pain disappeared, the treatment of patients with satisfaction.

Vaginismus: A painful spasm and contraction of the muscles of the vagina that prevents sexual intercourse. The condition results in pain when vaginal sexual intercourse is attempted or, in some cases, during a pelvic examination by a health-care provider. Vaginismus is not common, and its cause is poorly understood. Anxiety, past sexual trauma, or other psychological conditions have been suggested as potential contributing factors. Vaginismus is considered to be a form of female sexual dysfunction. Treatment of vaginismus involves education, counseling, and the use of vaginal dilation exercises and acupuncture.

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J R Soc Med. 1999 Nov;92(11):579-81.

Acupuncture for vulvodynia.

Abstract

Vulvodynia is the sensation of burning and/or pain of the vulva in the absence of abnormal clinical findings. We offered acupuncture to twelve patients with this syndrome. All had experienced severe distress and impairment of sexual function and usual treatments had failed. The patients attended weekly for acupuncture and progress was monitored at each visit by enquiry, a questionnaire and a visual analogue scale for pain. Half had treatment for the first five weeks only, the other half for the second five weeks only. Side-effects were negligible. Two patients felt so much improved that they declared themselves ‘cured’; three believed their symptoms had improved and wished to continue acupuncture; four felt slightly better and judgedacupuncture more effective than any other treatment; and three noted no effect at all. Acupuncture is time-consuming and a large part of its beneficial effect in this study may have come from the regular specialist contact. However, in view of the patients’ lack of response to other measures their satisfaction with the acupuncture was surprisingly high.

PMID:10703496 [PubMed – indexed for MEDLINE] PMCID: PMC1297434   Free PMC Article

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