Pain, psychosocial, sexual, and psychophysical characteristics of women with primary vs. secondary provoked vestibulodynia.
BACKGROUND
Women with provoked vestibulodynia (PVD), a common cause of dyspareunia, are typically considered a homogeneous group. However, research suggests that differences on some factors (e.g., medical history, pain characteristics, psychological functioning, treatment response) exist based upon whether the pain was present at first intercourse (primary PVD: PVD1) or developed at some later point (secondary PVD: PVD2).


OBJECTIVE
The purpose of this study was to examine differences in demographic variables, pain characteristics, psychosocial and psychosexual adjustment, and pain sensitivity between women with PVD1 and PVD2.


METHODS
Twenty-six women suffering from PVD (13 with PVD1 and 13 with PVD2) completed a screening assessment, a standardized gynecological examination, an interview, questionnaires, and a quantitative sensory testing session.


METHODS
These included pain ratings during the gynecological examination and interview, scores on measures of psychosocial/sexual functioning (e.g., Short Form-36 [SF-36] Health Survey, Female Sexual Function Index), and thresholds and pain ratings during thermal sensory testing over the dominant forearm and vulvar vestibule.


RESULTS
The women with PVD1 were more likely to be nulliparous, but they were not significantly different from the women with PVD2 on other demographic variables or in their pain ratings during the gynecological examination. The women with PVD1 reported lower levels of social and emotional functioning and heightened anxiety surrounding body exposure during sexual activity, and they also displayed lower heat pain tolerance over the forearm and lower heat detection and pain thresholds at the vulvar vestibule than the women with PVD2.


CONCLUSIONS
The findings from this study support previous research indicating that women with PVD1 and PVD2 differ in a number of domains. Further research is needed to confirm and elaborate on these findings.
Sutton
Katherine S
KS
Department of Psychology, Queen's University, Kingston, Ontario, Canada. 5kss1@queensu.ca
Pukall
Caroline F
CF
Chamberlain
Susan
S
D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004414:Dyspareunia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006358:Hot Temperature; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology*; D017288:Pain Threshold; D011584:Psychology; D011601:Psychophysics; D012725:Sexual Behavior / Q000523:psychology; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013697:Thermosensing / Q000502:physiology*; D054515:Vulvar Vestibulitis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult