Neurontin (gabapentin), a medication used off-label to treat chronic pain, alleviates discomfort and improves sexual function in women with pain during intercourse and provoked vulvodynia, a study has found.
The study, “Effect of gabapentin on sexual function in vulvodynia: a randomized, placebo-controlled trial,” was published in the American Journal of Obstetrics and Gynecology.
Provoked vulvodynia is a medical condition characterized by discomfort and chronic pain around the vulva (vaginal entry) triggered by sexual intercourse, tampon insertion, or even a gynecological exam. Vulvodynia can also be associated with endometriosis, a disorder that can cause pelvic pain, infertility, painful or irregular periods (dysmenorrhea), painful sexual intercourse (dyspareunia), and mental health issues.
“Previous studies have suggested [Neurontin] reduces the pain of fibromyalgia, a chronic condition that includes widespread pain in various parts of the body. Our theory was that reducing pelvic floor muscle pain might reduce vulvodynia pain overall and thus improve sexual function,” Gloria Bachmann, MD, director of the Women’s Health Institute at Rutgers Robert Wood Johnson Medical School and lead author of the study, said in a press release.
To test this hypothesis, Bachmann’s team carried out a multicenter, double-blind, randomized crossover trial (NCT1301001) to evaluate the effects of Neurontin on sexual function compared with a placebo in women with provoked vulvodynia over a period of 18 weeks.
Sexual function was measured by the Female Sexual Function Index (FSFI). Besides comparing the effects of Neurontin to a placebo, the researchers also compared their findings in treated women with provoked vulvodynia with age- and race-matched women without chronic pain.
Between 2010 and 2016, researchers screened a total of 230 women, who had an average age of 37 and were diagnosed with provoked vulvodynia. From this group, 89 women who met the eligibility criteria were randomly assigned to receive either Neurontin (45) or a placebo (44) for a period of 18 weeks. A total of 66 women completed the trial.
Data revealed that women treated with Neurontin had a general improvement in sexual function compared with women treated on a placebo. This overall positive effect included significant improvements in sexual desire, arousal, and satisfaction.
“Our data, although statistically significant, showed minimal numeric improvement between [Neurontin] and placebo as measured by the FSFI. The increase in placebo response may have been affected by the instructional examinations and clinical counseling that were given to participants. These non-pharmacologic interventions may have contributed to a more positive attitude towards sexual function,” the researchers said in the study.
However, despite the positive outcomes, the overall sexual function of women with vulvodynia treated with Neurontin remained lower than that of 56 age- and race-matched women without any pain disorder.
Investigators found that women with higher pain scores were also the ones experiencing the best treatment responses, “which clinically may translate to considering [Neurontin] as an initial treatment option in women with [provoked vulvodynia] who report more severe muscle pain on pelvic floor examination.”