Does the addition of electrical stimulation or kinesiotherapy improve outcomes of amitriptyline treatment for women with vulvodynia? A randomized clinical trial

Introduction and hypothesis Women diagnosed with provoked vulvodynia frequently report a great deal of frustration in achieving symptomatic relief. Physical therapy and drug treatment are among the interventions most indicated by guidelines; however, whether those modalities are effective when combined remains unclear. The objective was to evaluate the effectiveness of adding a physical therapy modality compared with amitriptyline alone for the treatment of vulvodynia. Methods Eighty-six women with vulvodynia were randomized to (G1) 25 mg amitriptyline, once a day ( n =27), (G2) amitriptyline + electrical stimulation therapy ( n =29) or (G3) amitriptyline + kinesiotherapy ( n =30). All treatment modalities were administered for 8 weeks. The primary endpoint was the reduction in vestibular pain. Secondary measurements focused on sexual pain, frequency of vaginal intercourse, Friedrich score, and overall sexual function. Data were analyzed using intention-to-treat. Results All treatment modalities resulted in a significant decrease in vestibular pain ( p