Vulvodynia

Eppsteiner, Erin E; Boardman, Lori A.; Stockdale, Colleen K.

doi:10.1016/j.bpobgyn.2014.07.009

Cited by 21 publications

(33 citation statements)

References 64 publications

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“…Research has explored several causative factors including neuropathic pain, psychosocial influences, and infection; however, the etiology remains unknown, and successful therapy often involves a multidisciplinary approach (Eppsteiner et al, 2014). The subjective impact of vulvodynia is idiosyncratic, but common difficulties include using tampons, sitting, wearing jeans, tights, or trousers, engaging in penetrative sex, or exercising, which in turn impact on women’s day-to-day functioning, including both employment, leisure, and caring activities.…”

Section: Introductionmentioning

confidence: 99%

Women’s Experiences of Vulvodynia: An Interpretative Phenomenological Analysis of the Journey Toward Diagnosis

et al. 2018

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Vulvodynia is the experience of idiopathic pain characterized by burning, soreness, or throbbing in the external female genitalia or vulva and is estimated to be experienced by 4-16% of the female population, yet only half of women seek help regarding their symptoms. Of the women who do seek help, only around 2% obtain a diagnosis. Therefore, the aim of the current study was to explore the experiences of women with vulvodynia on their journey toward diagnosis, by using semi-structured interviews and an interpretative phenomenological analysis (IPA) methodology. Eight women were interviewed, and their experiences were analyzed and interpreted into three master themes, each with constituent sub-themes: (1) The Journey Is a Battle, (2) "What Is Vulvodynia?": Ambivalence Toward Diagnosis, and (3) Patriarchy, Women, and Sex. Overall, women perceived a healthcare system which was dismissive and shaming, with an inadequate knowledge of vulvodynia. This in turn impacted on women's psychological well-being. Psychological understanding, one-to-one therapy, and consultation and training for healthcare professionals may help to improve the psychological well-being of women with vulvodynia.

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Section: Introductionmentioning

confidence: 99%

Women’s Experiences of Vulvodynia: An Interpretative Phenomenological Analysis of the Journey Toward Diagnosis

et al. 2018

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“…Current treatment strategies follow a “trial and error” approach guided mainly by expert opinion rather than an evidence-based approach from randomized clinical trials (RCTs) 26 . Under this strategy, the degree of therapeutic intervention increases as symptoms fail to remit or worsen.…”

Section: The Elusive Origins Of Vulvodynia and The Unsurprising Treatmentioning

confidence: 99%

“…However, a recent placebo-controlled RCT found that desipramine alone or in combination with lidocaine performed no better than placebo 36 . Other antidepressants, such as serotonin reuptake inhibitors, are also largely ineffective for vulvodynia 26 . Although early theories suggested that unexplained vulvar pain represents a strictly psychological disorder 10 , depression, hypervigilence, and catastrophizing are now regarded as evolving as the chronic pain state persists 5 .…”

Section: The Elusive Origins Of Vulvodynia and The Unsurprising Treatmentioning

confidence: 99%

“…However, pelvic floor dysfunction is likely secondary to and not the cause of vulvodynia 1,6 . Nonetheless, gabapentin has other indications for use; double-blind placebo-controlled studies indicate gabapentin is effective in relieving neuropathic pain 26 . Currently, the first multicenter RCT is underway to examine the efficacy of oral gabapentin 38 .…”

Section: The Elusive Origins Of Vulvodynia and The Unsurprising Treatmentioning

confidence: 99%

“…Therefore, it is imperative that we carefully examine the underlying mechanisms of disease and develop improved rationales for new therapies or enhanced formulations of current therapies. It is not our viewpoint that the current treatment modalities are invalid; most clinically implemented therapies do have at least some empiric evidence to support their use 5,6,26 . However, we envision a future where these therapies can be better implemented, along with new therapies targeting the inflammatory origins of disease.…”

Section: Towards Better Therapeuticsmentioning

confidence: 99%

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A review of the available clinical therapies for vulvodynia management and new data implicating proinflammatory mediators in pain elicitation

Falsetta

Foster

Bonham

et al. 2016

BJOG

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Localized provoked vulvodynia (LPV) is a common, chronic, and disabling condition; patients experience profound pain and a diminished quality of life. The etiologic origins of vulvodynia are poorly understood, yet recent evidence suggests a link to site-specific inflammatory responses. Fibroblasts isolated from the vestibule of LPV patients are sensitive to pro-inflammatory stimuli and copiously produce pain-associated pro-inflammatory mediators (IL‐6 and PGE2). Although LPV is a multifactorial disorder, understanding vulvar inflammation and targeting the inflammatory response should lead to treatment advances, especially for patients exhibiting signs of inflammation. NFkB (already targeted clinically) or other inflammatory components may be suitable therapeutic targets.

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The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document

Preti¹,

Vieira‐Baptista

Digesu³

et al. 2019

Neurourology and Urodynamics

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BACKGROUND The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology is controversial. AIMS In this best practice document, we propose recommendations for the use of LASER for gynecologic and urologic conditions such as vulvovaginal atrophy, urinary incontinence, vulvodynia, and lichen sclerosus based on a thorough literature review. MATERIALS & METHODS This project was developed between January and September 2018. The development of this document followed the ICS White Paper Standard Operating Procedures. RESULTS Most of the available studies are limited by their design; for example they lack a control group, patients are not randomized, follow up is short term, series are small, LASER is not compared with standard treatments, and studies are industry sponsored. Due to these limitations, the level of evidence for the use of LASER in the treatment of these conditions remains low and does not allow for definitive recommendations for its use in routine clinical practice. Histological evidence is commonly reported as proof of tissue regeneration following LASER treatment. However, the histological changes noted can also be consistent with reparative changes after a thermal injury rather than necessarily representing regeneration or restoration of function. The use of LASER in women with vulvodynia or lichen sclerosus should not be recommended in routine clinical practice. There is no biological plausibility or safety data on its use on this population of women. DISCUSSION The available clinical studies do not present convincing data regarding the efficacy of LASER for the treatment of vaginal atrophy or urinary incontinence. Also, while short‐term complications seem to be uncommon, data concerning long‐term outcomes are lacking. CONCLUSION At this point, LASER is not recommended for routine treatment of the aforementioned conditions unless part of well‐designed clinical trials or with special arrangements for clinical governance, consent, and audit.

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Vulvodynia

Cited by 21 publications

References 64 publications

Women’s Experiences of Vulvodynia: An Interpretative Phenomenological Analysis of the Journey Toward Diagnosis

Women’s Experiences of Vulvodynia: An Interpretative Phenomenological Analysis of the Journey Toward Diagnosis

A review of the available clinical therapies for vulvodynia management and new data implicating proinflammatory mediators in pain elicitation

The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document

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