title: Overlap between orofacial pain and vulvar vestibulitis syndrome.
abstract: OBJECTIVE
  To explore the prevalence of orofacial pain (OFP) among patients with vulvar vestibulitis syndrome (VVS) and to examine the relationship between signs and symptoms of OFP and clinical characteristics of women with VVS, we investigated differences in psychologic characteristics and severity of painful intercourse.
  
  
  METHODS
  In this cross-sectional exploratory study, 137 women with VVS completed questionnaires that assessed levels of pain, anxiety, somatization, and presence of signs and symptoms suggestive of clinical and subclinical OFP. Demographic data were gathered from medical records.
  
  
  RESULTS
  OFP was found to be a highly prevalent (78%) condition among women with VVS. Compared with women who had no OFP symptoms (n=30), those with symptoms (n=64) reported higher levels of anxiety (45.0 vs. 37.8, Bonferroni adjusted P=0.017), somatization (125.2 vs. 96.0, Bonferroni adjusted P<0.001), and psychologic distress (62.8 vs. 56.0, Bonferroni adjusted P=0.002). Although we observed a similar trend among women with subclinical OFP (n=43), this trend only reached statistical significance with respect to somatization. Differences were not detected for demographics, duration of pain, and severity of pain during intercourse across the 3 groups.
  
  
  CONCLUSIONS
  OFP is a common condition among women with VVS. Because severity and duration of painful intercourse did not differ by OFP classification but psychologic characteristics did, we must begin to question a unidimensional focus on vestibular mucosa as a reason for pain and persistent distress.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7570, USA . zolnound@med.unc.edu
authors.forename: Denniz A
authors.initials: DA
authors.lastname: Zolnoun
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Rohl
authors.forename: Charity G
authors.initials: CG
authors.lastname: Moore
authors.forename: Cara
authors.initials: C
authors.lastname: Perinetti-Liebert
authors.forename: Georgine M
authors.initials: GM
authors.lastname: Lamvu
authors.forename: William
authors.initials: W
authors.lastname: Maixner
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000209:etiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology; D005157:Facial Pain / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D010147:Pain Measurement; D015995:Prevalence; D011594:Psychometrics; D011795:Surveys and Questionnaires; D054515:Vulvar Vestibulitis / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology