Vestibulodynia is characterized by a severe, burning/sharp pain that occurs in response to pressure localized to the opening of the vagina called the vulvar vestibule. Dyspareunia (i.e., painful intercourse) is the defining symptom of vestibulodynia. Painful intercourse can be present from the first intercourse attempt (i.e., primary vestibulodynia) or it may develop after a period of pain-free intercourse (i.e., secondary vestibulodynia). It has been shown clearly by several authors that oral contraceptive pill use significantly increases the risk of developing vestibulodynia. In addition, it has been well described that oral contraceptive pills cause changes in blood levels of hormones (estradiol, free testosterone, and progesterone.) It has been shown that oral contraceptive pills cause changes in hormonal receptors as well as an altered tissue structure in the vulvar vestibular mucosa. The study investigators, and other authors, have hypothesized that these changes may cause thinning of the vulvar vestibule thereby causing vestibulodynia. This study is designed to see if replacing estrogen and testosterone in the vestibular tissue relieves the symptoms of vestibulodynia.

A double-blind trial of estradiol vs estradiol and testosterone vs placebo for women with secondary vestibulodynia that started while on oral contraceptive pills.