Investigating Intranasal Oxytocin as a Treatment for Women's Chronic Pelvic Pain: A Feasibility Study

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Chronic pelvic pain (CPP) affects approximately 5.7-26.6% of women in the general population and has limited treatment options. Administration of oxytocin (OT) has been associated with reductions in pain in other chronic pain conditions. The current feasibility study was the first to investigate the OT-pain association in women with CPP. The aims were: 1) determine if a clinically significant change in pain intensity (1-centimeter improvement on a 10-centimeter visual analogue scale) could be detected following intranasal OT administration; 2) identify challenges in treatment and study protocol implementation. Women with CPP (N=18) were recruited from chronic pain and gynecology clinics for this randomized, double-blind, within-subject crossover trial (Registration#NCT02888574). Exclusion criteria included pregnancy, primary diagnosis of endometriosis, dysmenorrhea, interstitial cystitis, functional bowel disorder, fibromyalgia, or neuropathic pain. Currently, 11 women have completed the trial (2-weeks OT, 2-weeks washout, 2-weeks placebo, with random order of OT and placebo). Women recorded symptoms of pain at baseline and in daily diaries. One participant dropped out due to headaches following placebo administration, one did not complete daily diaries, and two were randomized despite having pain only during intercourse, leaving seven women in the analyses. Clinically significant change was reported for average and current pain following OT and placebo administration. Self-reported treatment adherence was near perfect. Participants viewed the treatment as credible, anticipating improved pain. Daily diary adherence was good. Challenges with protocol implementation highlight the need for more systematic eligibility assessments and recruitment strategies, and moving daily diaries to an online platform. Overall, a clinically significant change was detected on pain and the treatment protocol was feasible, though some adjustments to the study protocol are warranted before a subsequent trial is completed.
Chronic pain, chronic pelvic pain, oxytocin, intranasal oxytocin, feasibility study, randomized clinical trial
Flynn, M. J. (2018). Investigating intranasal oxytocin as a treatment for women's chronic pelvic pain: A feasibility study (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from doi:10.11575/PRISM/32984