title: Vulvodynia and proctodynia treated with topical baclofen 5 % and palmitoylethanolamide.
abstract: BACKGROUND
  The prevalence of idiopathic vulvodynia and proctodynia is high. Pain management with anti-depressants and anti-epileptics may induce undesirable side effects. Therefore, topical baclofen cream and palmitoylethanolamide might be new therapeutic options.
  
  
  METHODS
  A 33-year-old woman with intractable chronic vulvar and anal pain had to abstain from sexual intercourse and could neither cycle nor sit for more than 5 min. The patient did not respond to standard treatments. We prescribed a combination of topical baclofen 5 % and palmitoylethanolamide 400 mg, three times daily. After 3 months her symptoms decreased more than 50 % and sexual intercourse was possible again without pain.
  
  
  CONCLUSIONS
  Topical baclofen and palmitoylethanolamide can be a viable treatment option in chronic vulvodynia and proctodynia.
authors.affiliation: Institute for Neuropathic Pain, Spoorlaan 37a, 3735 MV, Bosch en Duin, The Netherlands, jan@neuropathie.nu.
authors.forename: Jan M
authors.initials: JM
authors.lastname: Keppel Hesselink
authors.forename: David J
authors.initials: DJ
authors.lastname: Kopsky
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Sajben
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000577:Amides; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D001004:Anus Diseases / Q000188:drug therapy*; D001418:Baclofen / Q000008:administration & dosage / Q000627:therapeutic use*; D003075:Coitus; D004359:Drug Therapy, Combination / Q000379:methods; D063388:Endocannabinoids / Q000008:administration & dosage / Q000627:therapeutic use*; D004983:Ethanolamines / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy*; D010169:Palmitic Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D056650:Vulvodynia / Q000188:drug therapy*
chemical_list: D000577:Amides; D000894:Anti-Inflammatory Agents, Non-Steroidal; D063388:Endocannabinoids; D004983:Ethanolamines; D009125:Muscle Relaxants, Central; D010169:Palmitic Acids; C005958:palmidrol; D001418:Baclofen