Efficacy and Safety of Topical 5% Cannabidiol Plus Myrcene for the Treatment of Vestibulodynia: A Multi-Centric Randomized Controlled Trial.

Background/

Objectives

Vestibulodynia is the prevalent form of vulvodynia, causing burning, irritation, rawness, and dyspareunia sensations. This sensory abnormality suggests sensitization to neuropathic pain.

Methods

This was a randomized double-blind trial involving patients who applied a 5% cannabidiol gel with myrcene or a placebo to their vulvar vestibule for 60 days, assessing changes in dyspareunia, pain, and vestibular cotton swab test scores on a 0-10-point VAS scale.

Results

This study enrolled 40 women, with 20 in the active treatment group and 20 in the placebo group. All symptoms improved in both groups, but the active treatment group showed a greater reduction in VAS scores for pain and swab tests. However, dyspareunia improved significantly more in the active treatment group.

Conclusions

Cannabidiol's positive effects on vestibulodynia patients can be attributed to its antinociceptive and anti-inflammatory properties. It desensitizes transient vanilloid receptor potential channels subtype 1, which are found in peripheral C-fiber nociceptors and mast cells. The results also suggest that myrcene, a terpene found in cannabis, can inhibit peripheral sensitization exerted by cannabidiol.