What is vulvodynia?

Objectives:

Vulval pain, in the absence of pathology, may have a psychological basis that relates to life events. This study aimed to determine the nature of such events.

Design:

Structured questionnaire about patient's symptoms and early-life events.

Setting:

Private practice physiotherapist specialising in pelvic floor disorders. POPULATION: Patients with vulvodynia as their primary symptom and control patients being treated for urinary tract disorder or post-childbirth routine physiotherapy who had no vulval pain on direct questioning.

Methods:

Questionnaire applied to consecutive patients referred for treatment. Seventy-eight consecutive women presenting with vulvodynia (mean age 34 years, mean duration of symptoms 48 months) and 78 controls (mean age 39 years).

Main Outcome Measures:

Incidence of life events.

Results:

A similar proportion of both groups were married. Being in a new relationship (P < 0.04), adverse current or previous relationships (39 versus 9%, P < or = 0.01), parental divorce (26 versus 9%, P < or = 0.001), history of termination of pregnancy, and adverse childbirth experiences (P < 0.04) were more common in patients than in controls. A history of sexual abuse was not more common in patients with vulvodynia compared with controls (13 versus 10%, P = not significant). Lack of libido was common in patients with vulvodynia (94 versus 29%, P < 0.0001).

Conclusions:

Adverse life experiences, including conflict, are common in women with vulvodynia. These factors may be important in mediating the genesis of pain through stress-related mechanisms. Sexual interest is diminished in these women. Sexual abuse is not a factor in most of these women. These findings have implications for treatment.

Please click on the required question.

• 1 What skin conditions may affect the vulva?
• 2 Which viral infections can affect the genitalia?
• 3 What problems can occur to people with herpes simplex?
• 4 What are genital warts?
• 5 What is lichen sclerosus?
• 6 How is lichen sclerosus treated?
• 7 What could be causing my vulval irritation?
• 8 How could my vulval irritation be treated?
• 9 What is a Bartholin's cyst / abscess?
• 10 How is a Bartholin's cyst / abscess treated?
• 11 What is vulvodynia?
• 12 How can my vulvodynia be treated?
• 13 What is vestibulitis?
• 14 How can my vestibulitis be treated?
• 15 Where can I obtain further information?
• 16 Support Groups.

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