Effect of local estrogen therapy (LET) on urinary and sexual symptoms in premenopausal women with interstitial cystitis/bladder pain syndrome (IC/BPS).
The association between vulvodynia and interstitial cystitis/bladder pain syndrome (IC/BPS), a chronic, debilitating disease of unknown etiology, may involve sex hormone-dependent mechanisms regulating vulvo-vaginal health. We aimed to prospectively investigate the effects of 12 weeks of local estrogen therapy (LET) on urinary/bladder and sexual symptoms in premenopausal women with IC/BPS. Thirty-four women (mean age: 36.1 ± 8.4) diagnosed with IC/BPS were treated vulvo-vaginally three-times/week with estriol 0.5 mg cream and tested by validated questionnaires (ICSI/ICPI, pain urgency frequency [PUF], female sexual function index [FSFI]) and by cotton swab testing, vaginal health index (VHI) and maturation index (MI) before and after treatment. Vulvodynia was present in 94.1% of IC/BPS women. A significant positive effect of LET was evident on urinary and sexual function (p < 0.001, for both) following 12 weeks, as well as an improvement of the VHI (p < 0.001) and the MI (p < 0.04). The results of this open study indicate that 12 weeks of local estriol cream at vaginal and vestibular level may ameliorate urinary/bladder pain symptoms, as well as may improve domains of sexual function. The association between vulvar pain and bladder pain could, therefore, be related to a vaginal environment carrying signs of hypoestrogenism, but further studies are needed to clarify this issue.
a Research Centre for Reproductive Medicine, Section of Obstetrics and Gynecology, IRCCS Policlinico San Matteo , Pavia , Italy .|b Department of Clinical, Surgical, Diagnostic and Pediatric Sciences , University of Pavia , Pavia , Italy .
Barbara
B
Gardella
a Research Centre for Reproductive Medicine, Section of Obstetrics and Gynecology, IRCCS Policlinico San Matteo , Pavia , Italy .
Anna Daniela
AD
Iacobone
c Unit of Urology, Fondazione IRCCS San Matteo , Pavia , Italy , and.
Daniele
D
Porru
a Research Centre for Reproductive Medicine, Section of Obstetrics and Gynecology, IRCCS Policlinico San Matteo , Pavia , Italy .
Valentina
V
Musacchi
a Research Centre for Reproductive Medicine, Section of Obstetrics and Gynecology, IRCCS Policlinico San Matteo , Pavia , Italy .
Mattia
M
Dominoni
d Clinical Epidemiology and Biometric Unit, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy.
Carmine
C
Tinelli
a Research Centre for Reproductive Medicine, Section of Obstetrics and Gynecology, IRCCS Policlinico San Matteo , Pavia , Italy .|b Department of Clinical, Surgical, Diagnostic and Pediatric Sciences , University of Pavia , Pavia , Italy .
Arsenio
A
Spinillo
a Research Centre for Reproductive Medicine, Section of Obstetrics and Gynecology, IRCCS Policlinico San Matteo , Pavia , Italy .|b Department of Clinical, Surgical, Diagnostic and Pediatric Sciences , University of Pavia , Pavia , Italy .
Rossella E
RE
Nappi
D000282:Administration, Intravaginal; D000328:Adult; D018856:Cystitis, Interstitial / Q000188:drug therapy*; D004964:Estriol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D017697:Premenopause; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D056650:Vulvodynia / Q000188:drug therapy*
D004964:Estriol
Estrogens; genitourinary syndrome; sexual function; uro-genital system; vagina