title: [Evaluation of an estrogen vaginal cream for the treatment of dyspareunia: a double-blind randomized trial].
abstract: OBJECTIVE
  Our objective was to assess the short-term effect of an estrogen cream on symptoms associated with provoked vestibulodynia.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Service d'obstétrique-gynécologie, Centre hospitalier universitaire de Québec (Québec); Département d'obstétrique-gynécologie, Faculté de médecine, Université Laval (Québec).
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bazin
authors.affiliation: Service d'obstétrique-gynécologie, Centre hospitalier universitaire de Québec (Québec); Département d'obstétrique-gynécologie, Faculté de médecine, Université Laval (Québec).
authors.forename: Jessica
authors.initials: J
authors.lastname: Lefebvre
authors.affiliation: Service d'obstétrique-gynécologie, Centre hospitalier universitaire de Québec (Québec); Département d'obstétrique-gynécologie, Faculté de médecine, Université Laval (Québec).
authors.forename: Michel
authors.initials: M
authors.lastname: Fortier
authors.affiliation: Département de médecine sociale et préventive, Faculté de médecine, Université Laval (Québec).
authors.forename: Jacques
authors.initials: J
authors.lastname: Brisson
authors.affiliation: Faculté de pharmacie, Université Laval (Québec).
authors.forename: François
authors.initials: F
authors.lastname: Brouillette
authors.affiliation: Service d'obstétrique-gynécologie, Centre hospitalier universitaire de Québec (Québec); Département d'obstétrique-gynécologie, Faculté de médecine, Université Laval (Québec).
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bujold
authors.affiliation: Service d'obstétrique-gynécologie, Centre hospitalier universitaire de Québec (Québec); Département d'obstétrique-gynécologie, Faculté de médecine, Université Laval (Québec).
authors.forename: Céline
authors.initials: C
authors.lastname: Bouchard
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D004414:Dyspareunia / Q000188:drug therapy* / Q000503:physiopathology; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D010147:Pain Measurement; D016896:Treatment Outcome; D014622:Vaginal Creams, Foams, and Jellies / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D004966:Estrogens, Conjugated (USP); D014622:Vaginal Creams, Foams, and Jellies