Treatment of refractory vulvovaginal pruritus with naltrexone, a specific opiate antagonist

Chronic vulvovaginal pruritus can be refractory to standard treatment. Since opioids can induce itching and opioid receptor antagonists have been shown to suppress pruritus of different etiologies, we applied this treatment to patients with vulvovaginal pruritus refractory to conventional therapies.

Five women between 24 and 54 years of age suffering from chronic vulvovaginal pruritus were treated with 50mg naltrexone orally once a day for 3 weeks. They documented itching episodes and possible side-effects.

After 1 week of treatment the number of reported itching episodes decreased significantly to almost zero in all five patients. No further episodes of pruritus reoccurred during the following 2 weeks of treatment.

Treatment with the opiate antagonist naltrexone offers an alternative treatment option for patients with chronic vulvovaginal pruritus after exclusion of gynecologic, internal, and neurological causes of these symptoms.