Provides herein are compositions for the treatment of chronic vulval or perineal pain, and of symptoms or conditions associated therewith, comprising an estrogen, optionally estriol, and a tricyclic antidepressant, optionally amitriptyline, formulated for topical, transdermal or transmucosal administration. Also provided are methods for the production of said compositions and to uses thereof in the treatment of chronic vulval or perineal pain, and of symptoms or conditions associated therewith.
