New Treatment for Provoked Vestibulodynia (PVD)

I am so excited to share with you a new treatment for Provoked Vestibulodynia (PVD) called low level laser therapy.

PVD is defined as chronic, unexplained, vulvar pain in response to contact or pressure.

This pain may be in response to non-sexual activities such as tampon insertion, or gynecologic examination. Most patients with PVD present with painful intercourse or a complete inability to have intercourse. Symptoms may last for years and can have a very profound effect on women’s sexual and psychological well-being.

The exact cause of PVD remains unknown. It is thought to be caused by chronic inflammation, peripheral neuropathy, genetic, immunologic and hormonal factors. Other proposed causes include infectious process, psychological disorders, sexual dysfunction or disturbances in the central nerve system.

Since the exact mechanism of PVD is unknown, many treatments have been proposed, including topical preparations (lidocaine, estrogen, compounded medications). Other treatment include oral medications such as antidepressants and anticonvulsants.  Still some other options exist for PVD which include nerve blocks, pelvic floor physical therapy and lastly surgery.

There is insufficient evidence to conclude that any of the nonsurgical therapies actually work well for patients with PVD. Most of the available nonsurgical therapies present side effects which are not tolerated well by patients.  As a last resort many patients with PVD opt for surgery. The surgery is quite painful and involves a long down period for the patient.

Low level laser therapy involves the use of non-thermal laser irradiation to help modulate cell and tissue physiology to help heal PVD. Low level laser therapy is non-invasive, painless and can easily be administered in primary care settings.

In a randomized, placebo-controlled pilot trail by Dr. Ahinoam Lev-Sagie done at  the Hadassah-Hebrew University Medical Center showed the benefits of using low level laser therapy in patients with PVD.

The conclusion of this pilot trial showed that treatment with low level laser therapy safely and effectively reduced the symptoms of PVD.  Low level laser therapy has both a long-term and low cost effect on patients with PVD. Since low level laser therapy is non-invasive and painless Dr. Ahinoam Lev-Sagie recommends low level laser therapy prior to using any other treatment modalities.

On a recent trip to Israel, I had the opportunity to be trained on the use of low laser therapy in patients with PVD. I was most impressed by how well the patients did. Most of the patients I saw had exhausted a variety of other treatment options before being treated with low level laser therapy. The patients were all pain free after 12 treatments using low level laser therapy.

At Maze, we have purchased the Omega Low level Laser. I am thrilled to be able to offer it to our patients with Primary Vestibulodynia.