Friday, 22 November 2013

Two Year Pain Reduction Study


                This study caught my attention, as it predicts that women with vulvodynia have a natural decrease in pain over the span of two years. Here’s my review (will discuss my thoughts underneath):

This is a review of Women with Provoked Vestibulodynia Experience Clinically Signi´Čücant 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. The study set out to see how women with PVD and their symptoms evolve over time.

They hypothesized that:

A) there would be a significant decrease in pain over a two year period,

B) women who had had a vestibulectomy would report greater pain reductions than those with other forms of treatment and

C) women receiving multiple treatments would have significantly less pain and a better outcome psychosocially and sexually.

The study measured: pain intensity, sexual satisfaction, sexual function, depression, relationship satisfaction and sexual behaviour (more details on how these were measured on page 3). It was a pretty simple procedure: women were referred by their gynecologist or saw an advertisement and were sent a questionnaire package in the mail which they filled out and sent back. Two years later, if they still wished to participate, they were sent the questionnaire package again to be completed.

239 women filled out the questionnaires after the two years. The average age of women who participated was 30, the average duration of the pain in women was five and a half years and the average pain intensity for the women was 6.9/10. On the first questionnaire, women who had had a vestibulectomy reported having more pain, and those undergoing other treatments had less pain.  Physical therapy was the most used treatment in the first questionnaire (treatments used by women are shown in table 1 on pg. 4).

Over the two years, overall, pain and depressive symptoms DECREASED and sexual function and satisfaction INCREASED. All treatments except acupuncture reduced pain, even those who did not receive treatment had a reduction in pain. The study did not show that any one treatment is better than the other (including vestibulectomy’s).

This is a refreshing study for me, as most studies are poorly done, or show no significant effect in curing vulvodynia or even in reducing the symptoms. I also found this study intriguing because my vulvodynia is primary, and I’ve found the complete opposite in my pain and depressive symptoms: over the years mine have increased. So my only complaint about the study is the lack of differentiation between the types of vulvodynia (primary vs. secondary; provoked vs. unprovoked; generalized vs. localized). But this does show hope for those of you who have secondary vulvodynia, maybe patience (along with a bit of mindfulness) will be part of your journey towards pain reduction! Woohoo!

Reference of study: Davis, Seth N P, et al. "Women With Provoked Vestibulodynia Experience Clinically Significant Reductions In Pain Regardless Of Treatment: Results From A 2-Year Follow-Up Study." The Journal Of Sexual Medicine (2013): MEDLINE with Full Text. Web. 22 Nov. 2013.
Can be found at: Two Year Pain Reduction

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