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Hormonal Contraceptive Use and the Risk of Provoked Vestibulodynia

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01741948
Recruitment Status : Withdrawn (the study has never started. my grant request was denied.)
First Posted : December 5, 2012
Last Update Posted : February 10, 2015
Hadassah Medical Organization
Information provided by (Responsible Party):
ahinoam lev sagie, Clalit Health Services

Brief Summary:
There have been reports in the medical literature demonstrating a link between the development of provoked vestibulodynia (PVD), a sexual pain disorder, and hormonal contraceptive (HC) use. The purpose of this pilot study is to assess the prevalence of HCs induced PVD among a HC naïve population, to evaluate which of the components of the HCs are associated with a higher risk of the development of PVD, and to evaluate which clinical and genetic factors predispose the patient to HCs induced PVD. Assessments will be made through patient questionnaires, physical examinations, and blood tests. Microarray techniques will be employed to characterize, on a global level, the gene expression profiles of women who develop PVD in comparison to those who do not develop PVD. Patients will be followed for a year. Results will be used to develop a larger clinical trial.

Condition or disease Intervention/treatment
Vestibulodynia Drug: Hormonal contraceptive

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Study Type : Observational
Actual Enrollment : 0 participants
Observational Model: Case-Control
Time Perspective: Prospective
Official Title: Hormonal Contraceptive Use and the Risk of Provoked Vestibulodynia- A Prospective Study
Study Start Date : January 2012
Actual Primary Completion Date : December 2013
Actual Study Completion Date : December 2013

Resource links provided by the National Library of Medicine

Group/Cohort Intervention/treatment
First time users of hormonal contraceptive Drug: Hormonal contraceptive

The study will follow patients who are first time users of HCs for a full year after initiation. Patients will be followed every 3 months via questionnaires, blood examinations, and gynecologic examination, in case dyspareunia evolves.

First appointment (before initiation of HCs):

Questionnaire FSFI (Female Sexual Function Index) questionnaire. Blood collection for hormones levels and extraction of mononuclear blood cells. A gynecologic exam intended to rule out existing problem which causing dyspareunia.

3,6,9,and 12 months after initiation of HCs or anytime if a patient has dyspareunia:

Questionnaire evaluating possible influence of HCs use (dyspareunia, lubrication and libido).

FSFI questionnaire. Blood collection Gynecologic examination, designated to assess the cause of pain, including assessment of vestibular tenderness, muscle tightness and tenderness, pressure-pain thresholds measurement using vulvar algesiometer, pH measurement and vaginal swab for microscopy.

Primary Outcome Measures :
  1. Prevalence of hormonal-contraceptive induced provoked vestibulodynia [ Time Frame: One year ]
    one year for patients' enrollment and another year for follow up.

Secondary Outcome Measures :
  1. Hormonal contraceptive components associated with higher risk of HCs induced PVD [ Time Frame: One year ]
    Dose of ethinyl estradiol (15, 20 and 30 mcg) The progesterone component

  2. Clinical factors associated with HCs induced PVD [ Time Frame: One year ]
    Age at menarche Length of use Body mass index

  3. Biochemical markers associated with higher risk of HCs induced PVD [ Time Frame: One year ]
    Hormones: E2, testosterone Altered gene expression

Biospecimen Retention:   Samples Without DNA

Peripheral blood cells will be extracted from all blood samples. mRNA will be purified from all samples. The mRNA will be divided to aliquots and will be frozen in -80°C until further processing after all cohort samples have been collected.

mRNAs will be purified from whole blood using the QIAamp RNA purification kit (Quiagen Germany). A DNase I (Qiagen) digestion step is included in order to eliminate genomic DNA.

Serum will be collected from all blood samples. It will will be frozen in -70°C until further processing after all cohort samples have been collected.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 35 Years   (Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
The study will follow patients who are first time users of HCs for a full year after initiation. Patients will be recruited in a gynecology clinic affiliated with the "Clalit" Health Maintenance Organization in Jerusalem, Israel (Merkaz Briut Haisha, Ramat Eshkol, Jerusalem). This is a primary care government funded clinic, treating a diverse population.

Inclusion Criteria:

  • 200 non pregnant women between 18-35 naïve to HCs or other hormonal medications.
  • Patients able to provide Informed Consent and complete questionnaires.
  • Patient intends to use HCs for at least one year.
  • On exam before initiation of HCs, patient does not have primary PVD, pelvic floor hypertonicity, vaginismus or congenital abnormalities.
  • Patient will be available for follow up appointments.
  • Patient is willing to undergo gynecologic examination, if dyspareunia develops.

Exclusion Criteria:

  • Patients with endocrine disturbances (including PCOS), liver diseases and eating disorders.
  • Patients who suffer from Hypertension, Migraine with aura or clotting disturbances.
  • Patients that experience pain with intercourse or tampon insertion.
  • Patients that have other contraindications for HCs use

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01741948

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Clalit health Services
Jerusalem, Israel
Hadassah Medical Organization
Jerusalem, Israel
Sponsors and Collaborators
ahinoam lev sagie
Hadassah Medical Organization
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Principal Investigator: Ahinoam LevSagie, MD Clalit Health Services

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Responsible Party: ahinoam lev sagie, Principal Investigator, Clalit Health Services Identifier: NCT01741948    
Other Study ID Numbers: Levsagie OCP PVD
First Posted: December 5, 2012    Key Record Dates
Last Update Posted: February 10, 2015
Last Verified: February 2015
Keywords provided by ahinoam lev sagie, Clalit Health Services:
Provoked vestibulodynia
Hormonal contraceptives
Additional relevant MeSH terms:
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Vulvar Vestibulitis
Vulvar Diseases
Contraceptive Agents
Reproductive Control Agents
Physiological Effects of Drugs