Treating Where it Hurts: A Randomized Blinded Clinical Trial of Local Estrogen to the Vulvar Vestibule for Dyspareunia in Postmenopausal Women
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Change in Median Dyspareunia Pain Scores After 4 Weeks Using Study Drug
研究概览
简要总结
The purpose of this study is to compare the effectiveness of two low doses of estrogen cream applied to a new location for the treatment of moderate or severe pain during sexual intercourse in postmenopausal women.
详细描述
Estrogen cream is FDA-approved for vaginal use for the treatment of sexual pain, but its use in a new location is experimental. Pain with sex is a common problem experienced by women after menopause and the relationship of pain to sexual difficulties is well established. The cause has been assumed to be atrophy and the location has been assumed to be the vagina. Recent focused studies have shown that the location of pain is the vulvar vestibule and usually not the vagina. This study will look at pain before and after therapy with estrogen when only the vulvar entryway area is treated. This will be a study focused on sexual dysfunction in postmenopausal women.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
盲法说明
Double Blind
入排标准
- 年龄范围
- 40 Years 至 70 Years（Adult, Older Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Postmenopausal women aged 40 to 70 years old.
- •Postmenopausal, demonstrated by at least one of the following:
- •i. Cessation of menses for ≥1 years if age is >50 ii. Bilateral oophorectomy iii. A history of climacteric symptoms if below age 50, having an ovary and scarred or absent uterus.
- •Onset of dyspareunia after menopause.*
- •Stable heterosexual partnership ≥2 years (or by investigator discretion if less than 2 years) and both partners want to have more satisfying penetrative intimacy.
- •No estrogen product use, local or systemic, for 6 months.*
- •More than 6 months of consistent insertional pain with intercourse (may have stopped having intercourse due to this consistent experience of pain).*
- •Willingness to enter a study where she will receive low-dose local estrogen.*
- •Willingness to enter a study that requires application of cream on a frequent schedule for 3 months. *
- •Willingness to evaluate the progress of therapies by use of the Tampon Test as many as 2 times per week, and willingness to attempt intercourse if the Tampon Test indicates tolerable penetrative pain.*
- •n/a for reference group
排除标准
- •Consistently has pain in the pelvis or low abdomen during or after intercourse (deep dyspareunia).
- •Negative cotton-swab touch test in the vulvar vestibule or vestibular tenderness that is not extinguishable by application of lidocaine 4% topical solution applied for 3 minutes.
- •Partner with sexual dysfunction limiting his performance or making it inconsistent. (The use of male therapy for erectile dysfunction is acceptable.)
- •Diagnosis by a physical therapist or clinician of significant pelvic floor muscle tension causing pain (pelvic floor myalgia) or has been found on screening examination to have pelvic floor tenderness or bladder tenderness.
- •Constant burning pain localized to the vulva.
- •Allergy to local estrogen products or lidocaine numbing agents.
- •Previous estrogen receptor positive breast cancer or endometrial cancer.
- •Endometrial thickness ≥5mm on screening via transvaginal ultrasound.
研究组 & 干预措施
50mcg estradiol cream
Subjects randomized to 50mcg of study medication will be issued a pump that will dispense 0.5gm of cream with each pump
干预措施: 50mcg estradiol cream (Drug)
100mcg estradiol cream
Subjects randomized to 100mcg of study medication will be issued a pump that will dispense 0.5gm of cream with each pump
干预措施: 100mcg estradiol cream (Drug)
结局指标
主要结局
Change in Median Dyspareunia Pain Scores After 4 Weeks Using Study Drug
时间窗: Baseline to 4 weeks
Change in median dyspareunia pain scores between baseline and 4 weeks of use of nightly use of study medication. Pain will be assessed using 11-point Numerical Rating Scale (NRS) where 0 = no pain and 10 = worst possible pain.
Change in Median Pain Scores for Intercourse After 12 Weeks Using Study Drug
时间窗: Baseline and 12 weeks
Difference in median dyspareunia pain scores between arms for intercourse at 12 weeks after use of nightly study medication for 90d. Pain will be assessed using 11-point Numerical Rating Scale (NRS) where 0 = no pain and 10 = worst possible pain.
次要结局
未报告次要终点
研究者
Jeffrey Jensen
Principal Investigator
Oregon Health and Science University