Life events in patients with vulvodynia

• Published in: BJOG : an international journal of obstetrics and gynaecology 2008-03, Vol.115 (4), p.509-514
• Main Authors: Plante, AF, Kamm, MA
• Format: Article
• Language: English
• Subjects: abuse; Adult; Biological and medical sciences; Child; Child Abuse - psychology; Domestic Violence - psychology; Family Relations; Female; Gynecology; Gynecology. Andrology. Obstetrics; Humans; Life Change Events; life events; Marital Status; Medical sciences; Pain; Pain - psychology; Parity; Pregnancy; psychological factors; Psychology; Questionnaires; Sexual Partners; vulval pain; Vulvar Diseases - psychology; Vulvodynia; Womens health
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/j.1471-0528.2007.01662.x

Objective  Vulval pain, in the absence of pathology, may have a psychological basis that relates to life events. This study aimed to determine the nature of such events. Design  Structured questionnaire about patient’s symptoms and early‐life events. Setting  Private practice physiotherapist specialising in pelvic floor disorders. Population  Patients with vulvodynia as their primary symptom and control patients being treated for urinary tract disorder or post‐childbirth routine physiotherapy who had no vulval pain on direct questioning. Methods  Questionnaire applied to consecutive patients referred for treatment. Seventy‐eight consecutive women presenting with vulvodynia (mean age 34 years, mean duration of symptoms 48 months) and 78 controls (mean age 39 years). Main outcome measures  Incidence of life events. Results  A similar proportion of both groups were married. Being in a new relationship (P < 0.04), adverse current or previous relationships (39 versus 9%, P ≤ 0.01), parental divorce (26 versus 9%, P ≤ 0.001), history of termination of pregnancy, and adverse childbirth experiences (P < 0.04) were more common in patients than in controls. A history of sexual abuse was not more common in patients with vulvodynia compared with controls (13 versus 10%, P = not significant). Lack of libido was common in patients with vulvodynia (94 versus 29%, P < 0.0001). Conclusions  Adverse life experiences, including conflict, are common in women with vulvodynia. These factors may be important in mediating the genesis of pain through stress‐related mechanisms. Sexual interest is diminished in these women. Sexual abuse is not a factor in most of these women. These findings have implications for treatment.