Vulvovaginal disorders: 4 challenging conditions
OBG Management. 2006 March;18(03):35-46
March 1, 2006|OBG Management
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How to identify and treat candidiasis, contact dermatitis, lichen sclerosus, and vestibulodynia
| Names of standard agents used | Amitriptyline (Elavil) |
| Nortriptyline (Aventyl, Pamelor) | |
| Desipramine (Norpramin) | |
| Imipramine (Tofranil) | |
| Standard dosing | Start with 10 mg; increase by 10 mg weekly to 100–150 mg |
| Side effects | Sedation, often transient |
| Constipation, must be actively managed | |
| Dry mouth | |
| Palpitations, tachycardia | |
| Sun sensitivity | |
| Cautions | Obtain EKG over 50 years or with cardiac history |
| Contraindicated in glaucoma | |
| Levels must be monitored if combined with SSRI | |
| Success | Slow change over 6–12 months in sensitivity to touch; ability to use tampon. Minimal pain with dilator use, penetration |
| Failure | Over 3 months at max dose without any improvement |
