From the Guidelines
Yes, Xylocaine (lidocaine) can be prescribed intravaginally for dyspareunia, as it has been shown to improve symptoms of vaginal pain and discomfort during sexual intercourse. According to the most recent and highest quality study, lidocaine can be offered for persistent introital pain and dyspareunia 1. A typical regimen involves applying lidocaine 2-5% gel or ointment to the vaginal opening or inside the vagina 10-20 minutes before sexual intercourse to reduce pain. Patients should be advised that their partner may experience some numbness during intercourse. For those with persistent symptoms, daily application rather than just before intercourse may provide better relief. Lidocaine works by temporarily blocking nerve signals in the treated area, reducing pain sensation. It's particularly helpful for women with vestibulodynia or localized vulvodynia. However, patients should be aware that lidocaine is a temporary solution and doesn't address underlying causes of dyspareunia. Some women may experience burning or irritation upon application, which typically resolves quickly. If symptoms persist despite lidocaine use, further evaluation is recommended to identify and treat the root cause of the pain.
Key Considerations
- Lidocaine can be used to alleviate symptoms of dyspareunia, but it is essential to address the underlying causes of the condition.
- Patients should be informed about the potential risks and benefits of lidocaine use, including the possibility of numbness in their partner during intercourse.
- A thorough evaluation is necessary to determine the best course of treatment for each individual patient.
Treatment Options
- Lidocaine 2-5% gel or ointment can be applied to the vaginal opening or inside the vagina 10-20 minutes before sexual intercourse.
- Daily application of lidocaine may provide better relief for patients with persistent symptoms.
- Other treatment options, such as vaginal moisturizers, gels, and oils, may also be helpful in alleviating symptoms of vaginal dryness and sexual pain.
Recommendations
- Lidocaine can be prescribed intravaginally for dyspareunia, but patients should be closely monitored for any adverse effects 1.
- Patients should be referred to a specialist, such as a gynecologist or sexual health specialist, if their symptoms persist or worsen despite treatment.
- A multidimensional treatment plan that addresses the underlying causes of dyspareunia is essential for effective management of the condition.
From the Research
Xylocaine for Dyspareunia
- Xylocaine, also known as lidocaine, is a topical anesthetic that can be used to relieve pain in various medical procedures 2, 3.
- Dyspareunia, or pain during coitus, is a common condition that affects approximately 10% to 20% of U.S. women, and can be caused by various factors such as vulvodynia, inadequate lubrication, vaginal atrophy, and pelvic floor dysfunction 4.
- While there is no direct evidence that xylocaine can be prescribed intravaginally for dyspareunia, studies have shown that topical lidocaine can be effective in reducing pain associated with vaginal procedures such as speculum examination and intrauterine device insertion 2, 3.
- In one study, self-administered vaginal lidocaine gel was found to reduce pain during speculum insertion, but not during intrauterine device insertion 2.
- Another study found that topical application of lidocaine-prilocaine cream on genital mucosa before speculum examination significantly reduced pain associated with the procedure 3.
- Additionally, a study on postmenopausal women with dyspareunia found that topical lidocaine extinguished pain at the vulvar vestibule, suggesting that it may be effective in reducing pain associated with dyspareunia 5.
Treatment Options for Dyspareunia
- Treatment for dyspareunia depends on the underlying cause and may include lubricants, pelvic floor physical therapy, topical analgesics, vaginal estrogen, cognitive behavior therapy, vaginal dilators, and other interventions 4, 6.
- Topical estrogen therapy is a common treatment for vaginal atrophy, a common cause of dyspareunia in postmenopausal women 6.
- Other treatment options, such as pelvic floor physical therapy and cognitive behavior therapy, may also be effective in reducing pain and improving sexual function in women with dyspareunia 4.