Provoked Vestibulodynia: A Neuropathic Pain Condition?
Dargie, Emma Elizabeth
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Provoked Vestibulodynia (PVD) is a common form of chronic genital pain, affecting approximately 12% of premenopausal women. Even though knowledge of vulvodynia has been present in the medical field for many years, it was previously thought to be of psychogenic origin and has never been thoroughly investigated for the purpose of pain classification. When investigating any pain condition, one of the most important distinctions to make is whether or not the pain is neuropathic. Even though this possibility has never been investigated in women with PVD, some have claimed that PVD pain contains elements of neuropathy, even treating this pain with medication created for neuropathic pain conditions. The purpose of this study was to use standardized measures and determine whether PVD may have a neuropathic component. Women with PVD completed an online survey assessing various pain and psychosocial variables. Their responses were compared with those of pain-free controls and women experiencing an established neuropathic pain condition, post-herpetic neuralgia (PHN). Women with PVD scored above established cut-offs on measures of neuropathic pain (NP). Further, for some NP measures there was no difference in scores between PVD and PHN women. Women with PVD also had similar psychosocial profiles as those with PHN, although women with PHN reported poorer health-related quality of life. Interestingly, the number of NP symptoms did not predict pain/psychosocial disturbance, or vary as a function of pain duration or intensity. Overall, these results lend support to the argument that PVD is a chronic pain condition. Further, these results indicate that women with PVD likely experience some form of NP. These results add to the understanding and classification of PVD, justifying further investigation, for example, via psychophysical testing and functional magnetic resonance imaging.