Vulvodynia is a common chronic pain syndrome which has been studied from different perspectives over the years with mixed results. Recently, the International Society for the Study of Vulvovaginal Disease (ISSVD) revised the definition and acknowledged that vulvar pain can be attributed to a diagnosable disorder (i.e. infections, dermatological diseases, neoplastic processes, neurological states) or be present without a specific or identifiable disorder. Pain can be generalized or localized, provoked or unprovoked, and when is localized to the vestibule is defined vestibulodynia.
Sexual dysfunction and dyspareunia are very common in women with vulvodynia which is an highly distressing condition with significant emotional correlates. By using a validated questionnaire, women with vulvodynia reported worse sexual function than healthy women and in comparison to women with other sexual dysfunction, reported comparable sexual arousal, desire, orgasm and satisfaction, but higher pain and difficulties with lubrication. However, whether or not psychosexual vulnerability is a risk factor to develop vulvodynia or is the consequence of a long-term painful experience is far from being clear, given the evidence that even other chronic pain syndromes, such as interstitial cystitis, may be associated to vulvodynia and share a common etiologic background.
The approach to vulvodynia is necessarily multidimensional and should include a multidisciplinary team in order to clarify the organic underlining factors eventually involved and the psychosexual issues in womenʼs history which may be responsible of a chronic pain syndrome affecting the vulva. Indeed, an integrated therapeutic strategy is warranted to help these women to cope with vulvodynia and to obtain successful remission.Le texte complet de cet article est disponible en PDF.