Light Therapy May be a Suitable Addition to Provoked Vestibulodynia Treatment

Provoked vestibulodynia (PVD) can be explained by pain experienced at the vaginal opening (vulvar vestibule) when touched, or when pressure is applied. Around one out of ten women will experience PVD (prior to menopause), which can also cause poor sexual function and quality of life. There are some pain management techniques as well as medical treatments that can potentially completely eliminate symptoms.

Some experimental therapies may be beneficial and are being tested for their effectiveness in managing PVD. One is photobiomodulation therapy (PBM), which involves a cold laser probe and uses red or near-infrared light applied to the injured tissues. It’s believed that this kind of light therapy sparks metabolism in the affected cells, which would then help produce more endorphins, growth hormones, protein, collagen, and cellular energy; all of which are beneficial to tissue healing and cell regeneration. At the same time PBM is thought to reduce inflammation, and the body mechanisms that cause inflammation.

In order to test the efficacy of PMD in this capacity, researchers conducted treatment on thirty pre-menopausal women. Of these, 16 received the full PMD procedure, and the other 14 received the control: a fake procedure with no effective light emitted from the probe used. All 15 weekly sessions lasted 45 minutes and were followed by a recording of pain measured by “pressure pain threshold” (PPT) administered by clinicians and measured in grams of pressure tolerated, as well as a “tampon test.” This involved the participant inserting and removing a dry tampon without lubricant or other assistance in a secluded room and recording their pain after on a scale of 1-10.

Main Findings

Researchers found that pain sensitivity reduction was greater in the test group (real PBM) than in the control group (placebo). The test group experienced a significant increase of 77.2g PPT, while the control group experienced a slight increase of 15g PPT. Researchers suggest this slight increase in the control group may be due to the placebo effect.

The tampon test revealed a similar trend. On a scale of 1-10, the test group’s responses dropped significantly, by 2.1 points, while the control group’s responses decreased only marginally in comparison, by 1.1 point. Again, this similarity in pain perception between the two groups may be due to the placebo effect.

Midpoint Testing and Overall Satisfaction

After eight sessions, there were significant improvements in pain tolerance from both groups, which suggests that PBM should be carried out for eight weeks at least in order to be fully effective. Additionally, 13% of the test group reported that they felt “much better” after the full course of treatment, compared to 0% of the control group. However, most patients admitted they felt only “better” or “about the same” after either the real or fake PBM treatments.

Conclusion

Overall, researchers found that PBM was significantly effective in treating PVD and improving pain sensitivity in pre-menopausal women. However, clinicians and patients should be mindful of the small sample size and short follow-up period involved in the study, which would deter claims regarding its generalizability and long-term efficacy.

Despite this, adherence to the procedure was very high, with only one participant dropping out, and one participant skipping a session due to personal injury. Because of this and the high satisfaction rates, researchers believe PBM may be a viable and effective procedure to include in a multidisciplinary approach to PVD treatment.

References:

I Antonio, F., Pukall, C., & McLean, L. (2025). Photobiomodulation therapy for the treatment of vulvar pain among those with provoked vestibulodynia: A randomized controlled trial. The Journal of Sexual Medicine, 22(4), 579–587. https://doi.org/10.1093/jsxmed/qdaf011