title: Vulvodynia: Assessment and Treatment.
abstract: BACKGROUND
  Vulvodynia constitutes a highly prevalent form of sexual pain in women, and current information regarding its assessment and treatment is needed.
  
  
  OBJECTIVE
  To update the scientific evidence published in 2010, from the Third International Consultation on Sexual Medicine, pertaining to the assessment and treatment of women's sexual pain.
  
  
  METHODS
  An expert committee, as part of the Fourth International Consultation on Sexual Medicine, was comprised of researchers and clinicians from biological and social science disciplines for the review of the scientific evidence on the assessment and treatment of women's genital pain.
  
  
  METHODS
  A review of assessment and treatment strategies involved in vulvodynia.
  
  
  RESULTS
  We recommend the following treatments for the management of vulvodynia: psychological interventions, pelvic floor physical therapy, and vestibulectomy (for provoked vestibulodynia). We also support the use of multidisciplinary treatment approaches for the management of vulvodynia; however, more studies are needed to determine which components are most important. We recommend waiting for more empirical evidence before recommending alternative treatment options, anti-inflammatory agents, hormonal agents, and anticonvulsant medications. Although we do not recommend lidocaine, topical corticosteroids, or antidepressant medication for the management of vulvodynia, we suggest that capsaicin, botulinum toxin, and interferon be considered second-line avenues and that their recommendation be revisited once further research is conducted.
  
  
  CONCLUSIONS
  A comprehensive assessment is needed to understand the pain experience of women presenting with vulvodynia. In addition, treatment typically progresses from less invasive to more invasive, and several treatment options are worth pursuing.
authors.affiliation: Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA. Electronic address: obstetrics@yahoo.com.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Goldstein
authors.affiliation: Department of Psychology, Queen's University, Kingston, ON, Canada.
authors.forename: Caroline F
authors.initials: CF
authors.lastname: Pukall
authors.affiliation: Department of Clinical Pharmacy, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: Candace
authors.initials: C
authors.lastname: Brown
authors.affiliation: Department of Psychology, Université de Montréal, Montréal, QC, Canada.
authors.forename: Sophie
authors.initials: S
authors.lastname: Bergeron
authors.affiliation: Beyond Basics Physical Therapy, LLC, New York, NY, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Stein
authors.affiliation: Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, PA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Kellogg-Spadt
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000008:administration & dosage; D000328:Adult; D001905:Botulinum Toxins / Q000008:administration & dosage; D002211:Capsaicin / Q000008:administration & dosage; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D004414:Dyspareunia / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007372:Interferons / Q000008:administration & dosage; D017773:Pelvic Floor / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D018689:Sensory System Agents / Q000008:administration & dosage; D012725:Sexual Behavior / Q000523:psychology*; D056650:Vulvodynia / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*
chemical_list: D065087:Acetylcholine Release Inhibitors; D018689:Sensory System Agents; D007372:Interferons; D001905:Botulinum Toxins; D002211:Capsaicin
keywords: Assessment; Diagnosis; Sexual Pain; Treatment; Vestibulodynia; Vulvodynia