The lidocaina is a drug that has long been used in various areas of medicine to reduce pain. In the form of a gel, cream or ointment, it can be applied directly to the affected area to relieve pain. For a long time, it has been one of the most widely used prescriptions by specialists to help women with vulvodinia relieve vulvar pain, especially before sexual intercourse.
Lidocaine for vulvodinia: how it works
Several studies have focused on the pain-relieving power of lidocaina in women suffering from vulvodinia: some have shown that when applied directly to the painful area, it actually reduces vulvar pain, making sexual intercourse easier. In fact, those suffering from vulvodinia often have an increased number of pain-sensitive nerve fibers: the active ingredient works by blocking pain signals from these nerves, reducing discomfort.
One such study for example evaluated the efficacy of nighttime application of 5% lidocaina ointment to treat vulvar vestibulitis. After an average of seven weeks of treatment, 76 percent of women reported being able to have intercourse, compared with 36 percent prior to treatment. The intercourse-related pain score was lower than before.
Expert Opinion
“The lidocaina is a local anesthetic that works by blocking sodium channels (those that transmit, along the nerves, messages between the brain and the muscles), preventing the propagation of nerve impulses that transmit the painful sensation,” explains Valentina Pecorari, a urologist specializing in pelvic floor health, vulvodinia and incontinence.
“The anesthetic action, however, is temporary and reversible: yes, a reduced sensitivity to pain is felt, but tactile sensitivity (to touch) remains, which travels on a different type of nerve fiber. The effect also is limited to the area where the lidocaina is applied or injected, with a rapid onset that can last from a few minutes to a few hours, depending on the site of application, mode of administration, and amount.”
She continues, “In the past, local infiltrations of vulvodinia and corticosteroids were administered to treat lidocaina, but due to the shortness of action and the mechanisms of inflammation, which, as was later seen, were not responsive to corticosteroids, the practice was abandoned.” However, lidocaina continued to be used in the form of local therapy, to be applied directly where needed. With apparent benefits for women, the specialist confirmed.
“Resorting to lidocaina for less painful intercourse is certainly an appealing alternative because of its immediate effects: it’s as if it ‘numbs’ the pain for a while. But not feeling pain does not mean that the nerves are not subjected to a traumatic event. On the contrary, this can further sensitize them and progressively increase neuralgic inflammation. To give an example, it would be like taking a painkiller for running with a tendon injury: you can only get worse and slowed, if not hindered, healing.”
The alternatives
“Topical pharmacologic and natural therapies, on the other hand, such as CBD (cannabidiol), oral therapies to stabilize mast cells, and local therapies such as Tens, electroporation, and pelvic floor rehabilitation, if prescribed by a multidisciplinary team and followed consistently, give long-term benefits,” assures Dr. Pecorari, who concludes: “Treatments for vulvodinia are different, and no one protocol can be identified that fits all, but one must first find the cause of the pain and establish a personalized therapy.
Nor can one ” try everything,” in the belief that something will surely take effect, because over-therapy sometimes has effects contrary to those hoped for. Therefore, no to do-it-yourself! Also remember that as long as the nerves are sore or as long as the muscle is contracted, having sexual intercourse is discouraged and can only slow or push healing away. Exactly as an injured ligament must be at rest in order to heal.”