Introduction and objectives: Chronic unexplained vulvar pain, commonly referred to as vulvodynia, affects up to 18% of the female population. Despite its high prevelance and associated distress, it is commonly overlooked, misdiagnosed and poorly managed. The presentation will identify potential mechanisms linking psychological and physiological processes in vulvodynia and propose effective management strategies. Method: The presentation is based on data derived from a retrospective review of 529 patients seen in treatment between the years of 2000-2006, who provided written consent for their files to be used for research purposes. The study was approved by The University of Adelaide Human Research Ehtics Committee. Results: The mean age of the 529 patients was 27.7 years; the average age of symptom onset was 22.8 years; and the average duration of symptoms was 5.0 years. Patients scored high on dimensions of anxiety and depression with both scores correlating with severity of pain. Surface electromyography (sEMG) scores confirmed a positive correlation between pelvic muscle dysfunction and chronic vulvar pain, but a negative correlation between pain duration and sEMG. Physiological measures provide evidence of a functional muscle contracture characterised by muscle shortening and progressive electrical quieting. Conclusion: Chronic pain must be viewed from a psychophysiological perspective and therapy to be effective must recognise the intricate interaction of psychological variables on physiological mechanisms mediating chronic vulvar pain. Conservative therapeutic interventions provided in conjunction with specialised medical care can lead to successful outcomes.
Conflict of Interest: None disclosed
Financial Support/Funding: None disclosed
Recorded: Sydney, Australia, April 2007
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