title: Women with provoked vestibulodynia experience clinically significant reductions in pain regardless of treatment: results from a 2-year follow-up study.
abstract: BACKGROUND
  Provoked vestibulodynia (PVD) is a prevalent genital pain syndrome that has been assumed to be chronic, with little spontaneous remission. Despite this assumption, there is a dearth of empirical evidence regarding the progression of PVD in a natural setting. Although many treatments are available, there is no single treatment that has demonstrated efficacy above others.
  
  
  OBJECTIVE
  The aims of this secondary analysis of a prospective study were to (i) assess changes over a 2-year period in pain, depressive symptoms, and sexual outcomes in women with PVD; and (ii) examine changes based on treatment(s) type.
  
  
  METHODS
  Participants completed questionnaire packages at Time 1 and a follow-up package 2 years later.
  
  
  METHODS
  Visual analog scale of genital pain, Global Measure of Sexual Satisfaction, Female Sexual Function Index, Beck Depression Inventory, Dyadic Adjustment Scale, and sexual intercourse attempts over the past month.
  
  
  RESULTS
  Two hundred thirty-nine women with PVD completed both time one and two questionnaires. For the sample as a whole, there was significant improvement over 2 years on pain ratings, sexual satisfaction, sexual function, and depressive symptoms. The most commonly received treatments were physical therapy, sex/psychotherapy, and medical treatment, although 41.0% did not undergo any treatment. Women receiving no treatment also improved significantly on pain ratings. No single treatment type predicted better outcome for any variable except depressive symptoms, in which women who underwent surgery were more likely to improve.
  
  
  CONCLUSIONS
  These results suggest that PVD may significantly reduce in severity over time. Participants demonstrated clinically significant pain improvement, even when they did not receive treatment. Furthermore, the only single treatment type predicting better outcomes was surgery, and only for depressive symptoms, accounting for only 2.3% of the variance. These data do not demonstrate the superiority of any one treatment and underscore the need to have control groups in PVD treatment trials, otherwise improvements may simply be the result of natural progression.
authors.affiliation: Université de Montréal, Department of Psychology, Montreal, QC, Canada.
authors.forename: Seth N P
authors.initials: SN
authors.lastname: Davis
authors.forename: Sophie
authors.initials: S
authors.lastname: Bergeron
authors.forename: Yitzchak M
authors.initials: YM
authors.lastname: Binik
authors.forename: Bernard
authors.initials: B
authors.lastname: Lambert
mesh_terms: D015746:Abdominal Pain / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D003075:Coitus; D004414:Dyspareunia / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010549:Personal Satisfaction; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D056650:Vulvodynia / Q000628:therapy*; D055815:Young Adult
keywords: Female Genital Sexual Pain; Outcomes; Pain; Provoked Vestibulodynia; Treatment