title: Co-morbid pain conditions and feelings of invalidation and isolation among women with vulvodynia.
abstract: Many women with vulvodynia also suffer from other chronic co-morbid pain conditions. Alone, these pain conditions are associated with feeling invalidated by others and feeling socially isolated. It is unclear, however, how the presence of additional pain co-morbidities are associated with the psychosocial wellbeing of women with vulvodynia. We used data from a survey administered by the National Vulvodynia Association. Women reported clinician-diagnosed vulvodynia, presence of co-morbid pain, and how often they felt that they felt no one believed their pain existed (invalidated) and isolated. Analyses determined prevalence of feeling invalidated or isolated, and the difference in prevalence when co-morbidities existed. Forty-five percent of these 1847 women with vulvodynia reported having at least one of the following five chronic pain conditions, chronic fatigue syndrome, endometriosis, fibromyalgia, interstitial cystitis, or irritable bowel syndrome. Adjusted baseline prevalence among all women of feeling invalidated was 9% and of feeling isolated was 14%. Having a co-morbid condition with vulvodynia, as well as having an increasing number of co-morbid conditions with vulvodynia, was significantly associated with the presence of feeling both invalidated and isolated. Chronic fatigue syndrome was the co-morbidity most strongly associated with feelings invalidation and isolation. One or more co-morbid pain conditions in addition to vulvodynia were significantly associated with psychosocial wellbeing. However, the temporality of the association could not be elucidated and therefore we cannot conclude that these pain conditions cause poor psychosocial wellbeing. Despite this, future studies should explore the utility of promoting validation of women's pain conditions and reducing social isolation for women with chronic pain.
authors.affiliation: Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MA, USA. nguyen@umn.edu
authors.forename: Ruby H N
authors.initials: RH
authors.lastname: Nguyen
authors.forename: Ali M
authors.initials: AM
authors.lastname: Ecklund
authors.forename: Richard F
authors.initials: RF
authors.lastname: Maclehose
authors.forename: Christin
authors.initials: C
authors.lastname: Veasley
authors.forename: Bernard L
authors.initials: BL
authors.lastname: Harlow
mesh_terms: D000328:Adult; D001294:Attitude to Health; D059350:Chronic Pain / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D004715:Endometriosis / Q000453:epidemiology / Q000523:psychology; D004812:Epidemiologic Methods; D015673:Fatigue Syndrome, Chronic / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D012934:Social Isolation / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D056650:Vulvodynia / Q000453:epidemiology* / Q000523:psychology; D014930:Women / Q000523:psychology*; D055815:Young Adult