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

Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology 2015 Aug 10 [Epub ahead of print]

Barbara Gardella, Anna Daniela Iacobone, Daniele Porru, Valentina Musacchi, Mattia Dominoni, Carmine Tinelli, Arsenio Spinillo, Rossella E Nappi

a Research Centre for Reproductive Medicine, Section of Obstetrics and Gynecology, IRCCS Policlinico San Matteo , Pavia , Italy