Tuesday 26 November 2013

So you Want to Understand Vulvodynia/Vestibulodynia?


                I realized that I never really gave you guys a very descriptive or good definition of vulvodynia or vestibulodynia. I also realized that I don’t really know the best way to describe it to you, so instead I am going to quote a bunch of journal article definitions for you! Here they are:

Definition from Sexual and Relationship Intimacy among Women with Provoked Vestibulodynia and Their Partners: Associations with Sexual Satisfaction, Sexual Function, and Pain Self-Efficacy by Katy Bois, Sophie Bergeron, Natalie O. Rosen, Pierre McDuff, and Catherine Grégoire: With a prevalence of 12% in community samples, provoked vestibulodynia (PVD) is the most common subtype of vulvodynia and is characterized by a recurrent and burning pain experienced when pressure is applied to the vulvar vestibule, such as during intercourse or the insertion of a tampon. Women with PVD are more likely to report lower sexual functioning and sexual satisfaction as well as more distress about their sexuality than women without PVD, and a reduced quality of life.

Definition from Enoxaparin Treatment for Vulvodynia A Randomized Controlled Trial by Yaniv Farajun, Doron Zarfati, Liora Abramov, Alejandro Livoff, and Jacob Bornstein: Vulvodynia is a cause of dyspareunia in women. This underdiagnosed condition inflicts physical pain and emotional distress on millions. During the course of their lifetime, 16% of women suffer for at least 3 months from burning, knife-like pain or pain on contact in the vulvar area. Vulvodynia is associated with an economic burden to both individuals and society, which is composed of the cost of direct and indirect health care services. It is also related to a relatively low quality of life. The etiology of vulvodynia remains an enigma, acceptable diagnostic criteria remain subjective, and treatment methods are still empirically based. In a recent review of published studies, success rates for medical treatments of vulvodynia vary between 13% and 67%. This compares with 61–94% for surgical treatment and 35–83% for behavioral treatments.

Definition from Women with Provoked Vestibulodynia Experience Clinically Significant Reductions in Pain Regardless of Treatment: Results from a 2-Year Follow-Up Study by Seth N.P. Davis, Sophie Bergeron, Yitzchak M. Binik, and Bernard Lambert: Provoked vestibulodynia (PVD) is a genital pain disorder in women characterized by burning and cutting pain at the vulvar vestibule. The prevalence rate among women in the general population is estimated to be 12%. Physiological and psychosocial mechanisms such as inflammation, pelvic floor muscle dysfunction, pain sensitization, and maladaptive pain cognitions have been suggested to explain etiology; however, there is no systematic evidence supporting any single pathway. Though pain is the primary symptom, PVD is also associated with sexual dysfunction and sexual dissatisfaction. Unfortunately, little is known about how PVD progresses over time.

Definition from A randomized comparison of group cognitive-behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis by Sophie Bergeron, Yitzchak M. Binik, Samir Khalife, Kelly Pagidas, Howard I. Glazer, Marta Meana, Rhonda Amsel: Chronic or recurrent pain involving the female reproductive system is a neglected, poorly understood, and costly women's health problem. Dyspareunia, or painful intercourse, a recurrent acute pain which can be located anywhere from the vaginal introitus to the uterus and adnexae, affects 10 - 15% of women in North America. Perhaps the most common type of premenopausal dyspareunia is vulvar vestibulitis syndrome, a condition characterized by a sharp, burning pain located within and limited to the vulvar vestibule (vaginal entry) and elicited primarily via pressure applied to the area. This distressing syndrome has no clear etiological determinants, although it has been associated with repeated yeast infections and other urogenital inflammatory conditions.

Definition from A Retrospective Study of the Management of Vulvodynia by
Yongseok Jeon, Youngjun Kim, Bosun Shim, Hana Yoon, Youngyo Park, Bongsuk Shim, Woosik Jeong and Donghyun Lee

Vulvodynia is a condition in women that is characterized by chronic vulvar pain. It may be present constantly, intermittently, or only with intromission during sexual intercourse. The term vulvodynia was originally coined by McKay, and it has been adopted by the International Society for the Study of Vulvar Disease Task Force to describe any vulvar pain. There are no standardized classifications for vulvodynia largely because it is a multifactorial condition in which certain subsets coexist within others. Generalized vulvodynia, or essential vulvodynia, usually occurs in postmenopausal or perimenopausal women and is exhibited by diffuse, unremitting, and burning pain that is not cyclic. This pain may occur in different areas of the vulva at different times, and it may be constant or occur only every once in a while. Vulvar vestibulitis syndrome is specifically characterized by pain in the vestibule and usually occurs in premenopausal women. In this condition, pain occurs with vaginal entry by the penis or a tampon. Patients with vulvodynia usually describe their pain as a chronic burning in the vulvovestibular area that typically lasts more than 3 months. Before a diagnosis of vulvodynia is made, other vulvovaginal problems should be ruled out. Vulvodynia not only causes pain, but often leads to sexual dysfunction, including arousal and orgasmic difficulty. For many women, it reduces overall personal health and quality of life.
                If anyone wants access to these articles or has any questions leave a comment! Hope this helps anyone confused or unsure an out what vulvodynia is!

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