Vulvodynia: new thoughts on a devastating condition.

Vulvodynia affects 3% to 15% of women; many suffer through years of misdiagnosis and for those who receive care cures are uncommon. Little is known about the etiology and a wide range of therapeutic options are available. With treatment approximately 50% of women will report sustained improvement in pain scores of 50% or more, however, reasons for varied response rates are yet unknown. This article will explore 3 factors that may contribute to inconsistent results with therapy; the hypothesis that vulvodynia is a systemic disorder; the idea that failure to address the psychological or emotional aspect or chronic pain may affect outcome; and the concept that chronic vulvar pain, like headache, is not a single condition but is a diverse group of disorders that produce the same symptom.

BACKGROUND

Obstetricians & Gynecologists, Family Physicians

OBJECTIVE

After completion of this article, the reader should be able to state that vulvodynia is a complex disorder, explain that no one treatment is superior, relate that pathophysiology is important, and recall that psychological aspects of chronic pain must be appreciated.