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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EFor breast cancer survivors who experience moderate or severe penetrative dyspareunia associated with vulvovaginal atrophy, application of a topical liquid lidocaine to the vulvar vestibule prior to penetration can prevent pain and offer these women comfortable intercourse. This article discusses the outcomes of the Therapy to Prevent Sexual Pain in Breast Cancer Survivors trial (\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01539317\u0026amp;atom=%2Fspmdc%2F14%2F7%2F11.1.atom\u0022\u003ENCT01539317\u003C\/a\u003E).\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ESexual Dysfunction Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EBreast Cancer\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ESexual Dysfunction\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EObstetrics \u0026amp; Gynecology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EObstetrics \u0026amp; Gynecology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EBreast Cancer\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EFor breast cancer survivors who experience moderate or severe penetrative dyspareunia associated with vulvovaginal atrophy, application of a topical liquid lidocaine to the vulvar vestibule prior to penetration can prevent pain and offer these women comfortable intercourse.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EMartha F. Goetsch, MD, MPH, of Oregon Health and Science University, Portland, Oregon, USA, reported outcomes of the Therapy to Prevent Sexual Pain in Breast Cancer Survivors trial (\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01539317\u0026amp;atom=%2Fspmdc%2F14%2F7%2F11.1.atom\u0022\u003ENCT01539317\u003C\/a\u003E). This was a randomized, controlled, double-blind trial that was conducted to examine whether the use of an analgesic liquid to the vulvar vestibule in estrogen-deficient breast cancer survivors with moderate to severe dyspareunia could prevent pain from penetrative intercourse.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EForty-six estrogen-deficient breast cancer survivors were randomized to 4 weeks of either 4% liquid lidocaine or saline to be applied to the vulvar vestibule for 3 minutes prior to vaginal penetration. Study participants used a diary to document twice-weekly vaginal penetration by either intercourse or tampon insertion. This intervention phase of the study was followed by an 8-week open-label trial in which all patients received lidocaine.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe primary outcomes of the study were penetration pain (from either intercourse or tampon use) measured on a scale from 0 to 10, sexual distress as assessed by the Female Sexual Distress Scale (abnormal \u0026gt;11), and resumption of intercourse.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EAll women in the study had moderate to severe penetrative dyspareunia for more than 6 months. Women with significant pelvic muscle or organ pain, and those with vulvar dystrophy, were excluded from the study.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThe study showed that during the 1-month intervention phase, women who used lidocaine had significantly less pain during intercourse compared with those who used saline (median score, 1.0 vs 5.3; p=0.015).\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EAfter the 8-week open-label part of the study, completed by 41 of the 46 women, 90% (37 of 41) reported comfortable penetration as indicated by median scores of 0 and 1, and a significant decrease in the sexual distress score from a median of 30.5 at baseline to 14 (interquartile range, 3 to 20; p\u0026lt;0.001). Of the 20 women who abstained from sex prior to the study, 17 (85%) resumed intercourse after the study.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EProf. Goetsch emphasized that these results suggest that dyspareunia is more of a pain condition than one of atrophy, because the atrophy remained unchanged in these women. She also emphasized that successfully managing penetrative pain was achieved by targeting analgesic treatment to the vulvar vestibule, suggesting that the treatment target should be the vestibule, not the vagina.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EIn conclusion, the study shows that women can prevent their own pain from intercourse by using the lidocaine solution.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/7\/11.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzp8y2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}