Vulvodynia in Adolescence: Childhood Vulvar Pain Syndromes

Clare, Camille A.; Yeh, John

doi:10.1016/j.jpag.2010.08.009

Cited by 20 publications

(23 citation statements)

References 15 publications

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“…Classifications of vulvar pain may include localized or generalized pain, with the ability to have both,5,6 provoked or nonprovoked,5,7 and primary or secondary 8. Among the estimated 110 million chronic pain sufferers in the US, women with vulvodynia may be unique due to their high rate of comorbidity,9–12 the psychosocial impact of this condition,13–15 the young age at which the peak incidence occurs,16,17 and the potential for reproductive consequences 18,19…”

Section: Introductionmentioning

confidence: 99%

Latent class analysis of comorbidity patterns among women with generalized and localized vulvodynia: preliminary findings

Nguyen¹,

Veasley²,

Smolenski³

2013

JPR

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BackgroundThe pattern and extent of clustering of comorbid pain conditions with vulvodynia is largely unknown. However, elucidating such patterns may improve our understanding of the underlying mechanisms involved in these common causes of chronic pain. We sought to describe the pattern of comorbid pain clustering in a population-based sample of women with diagnosed vulvodynia.MethodsA total of 1457 women with diagnosed vulvodynia self-reported their type of vulvar pain as localized, generalized, or both. Respondents were also surveyed about the presence of comorbid pain conditions, including temporomandibular joint and muscle disorders, interstitial cystitis, fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, endometriosis, and chronic headache. Age-adjusted latent class analysis modeled extant patterns of comorbidity by vulvar pain type, and a multigroup model was used to test for the equality of comorbidity patterns using a comparison of prevalence. A two-class model (no/single comorbidity versus multiple comorbidities) had the best fit in individual and multigroup models.ResultsFor the no/single comorbidity class, the posterior probability prevalence of item endorsement ranged from 0.9% to 24.4%, indicating a low probability of presence. Conversely, the multiple comorbidity class showed that at least two comorbid conditions were likely to be endorsed by at least 50% of women in that class, and irritable bowel syndrome and fibromyalgia were the most common comorbidities regardless of type of vulvar pain. Prevalence of the multiple comorbidity class differed by type of vulvar pain: both (37.6% prevalence, referent), generalized (21.6% prevalence, adjusted odds ratio 0.41, 95% confidence interval 0.27–0.61), or localized (12.5% prevalence, adjusted odds ratio 0.31, 95% confidence interval 0.21–0.47).ConclusionThis novel work provides insight into potential shared mechanisms of vulvodynia by describing that a prominent comorbidity pattern involves having both irritable bowel syndrome and fibromyalgia. In addition, the prevalence of a multiple comorbidity class pattern increases with increasing severity of vulvar pain.

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Section: Introductionmentioning

confidence: 99%

Latent class analysis of comorbidity patterns among women with generalized and localized vulvodynia: preliminary findings

Nguyen¹,

Veasley²,

Smolenski³

2013

JPR

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“…Approximately 10–18% of American women have had symptoms consistent with vulvodynia at some point in their lives . Among the estimated 116 million American chronic pain sufferers, women with vulvodynia play a significant role in the chronic pain epidemic because of their high rate of co‐morbidity , the subsequent psychosocial impact of this condition , population‐level economic costs , the risk of reproductive consequences , and the young age at which peak incidence of vulvodynia occurs . The goal of medical intervention for vulvodynia is to reduce or eliminate pain, and in fact, remission from vulvar pain is thought to occur for some women .…”

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confidence: 99%

Perceived Stereotyping and Seeking Care for Chronic Vulvar Pain

et al. 2013

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Objectives We examined stereotyping of chronic pain sufferers among women aged 18 – 40 years and determined whether perceived stereotyping affects seeking care for women with chronic vulvar pain. Design Cross-sectional study using a community-based survey of vulvodynia asking if “Doctors think that people with chronic pain exaggerate their pain”, and if “People believe that vulvar pain is used as an excuse to avoid having sex”. Setting and Participants 12,834 women aged 18 – 40 years in metropolitan Minneapolis/St. Paul, Minnesota. Paul, Minnesota. Outcome Measures Women were considered to have a history of chronic vulvar pain if they reported vulvar burning lasting more than 3 months or vulvar pain on contact. Results 4,987 (38.9%) women reported a chronic pain condition; 1,651 had chronic vulvar pain. Women experiencing chronic pain were more likely than those without to perceive stereotyping from both doctors and others; a dose-response with the number of pain conditions existed. Women with chronic vulvar pain were more likely to believe that people think vulvar pain is an excuse to avoid intercourse. Half of the women with chronic vulvar pain did not seek medical care for it; of these, 40.4% perceived stereotyping from doctors. However, it was women who actually sought care (45.1%) who were more likely to feel stigmatized by doctors (adj. relative risk=1.11, 95% CI: 1.01-1.23). Conclusions Perceived negative stereotyping among chronic pain sufferers is common, particularly negative perceptions about physicians. In fact, chronic vulvar pain sufferers who felt stigmatized were more likely to have sought care than those who didn't feel stigmatized.

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“…Physical therapy-with an emphasis on pelvic floor physical therapy-is an effective treatment for musculoskeletal pain. Physical therapy is also useful in the treatment of adolescent vulvodynia, vaginismus, and endometriois [1, 4,37,39]. The use of biofeedback and self-vaginal dilators may be combined with pelvic floor physical therapy.…”

Section: Physical Therapymentioning

confidence: 99%

Gynecologic Pain in Adolescents

McCracken

2016

Curr Treat Options Peds

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Vulvodynia in Adolescence: Childhood Vulvar Pain Syndromes

Cited by 20 publications

References 15 publications

Latent class analysis of comorbidity patterns among women with generalized and localized vulvodynia: preliminary findings

Latent class analysis of comorbidity patterns among women with generalized and localized vulvodynia: preliminary findings

Perceived Stereotyping and Seeking Care for Chronic Vulvar Pain

Gynecologic Pain in Adolescents

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