Assessing Sensory Perception on the Vulva and on Extragenital Sites

Abstract

Quantitative sensory testing (QST) measures perception thresholds of defined intensities of physical stimuli (e.g. temperature, touch, pressure, vibration). The frequency and severity of subjective sensory effects (itch, burn), though less quantifiable, can be characterized under defined conditions such as product testing. This article reviews two sources of published research on sensory perception on the vulva relative to extragenital sites: (1) systematic, quantitative sensory testing with defined stimuli and (2) vulvar sensory effects reported in clinical trials of external feminine hygiene products. In healthy women, the vulva is less sensitive to punctate touch and vibration than other body sites. Vulvar sensitivity to mechanical stimuli declines after menopause, but is restored by estrogen supplementation. Product trials of feminine wet wipes suggest that vulvar perception of stinging and of skin wetness also are attenuated after menopause, although perceptions of burning or itching appeared to be unaffected. More systematic, standardized conditions are needed to validate the continued use of QST on the vulva and to better define the characteristics and intensity of subjective vulvar sensations.

Does Degree of Vulvar Sensitivity Predict Vulvodynia Characteristics and Prognosis?

“…10, 38 The vulva is ordinarily not very sensitive to pressure testing via QST, 14, 29 and pain sensitivity declines with age. 14 In addition, vulvar sensitivity has been shown to vary considerably, with some controls quite sensitive to pressure testing at the vulva, and some vulvodynia cases being as insensitive as many controls. 16 To further complicate the issue, the reproducibility and standardization of pressure testing at the vulva has varied substantially.…”

Sexual and Relationship Satisfaction and Vestibular Pain Sensitivity Among Women with Provoked Vestibulodynia

“…Of note, 12 of our pairs were matched within 2 years of each other. The remaining five women with PVD in our study were older (ranging from 30 to 40 years) and matched to a control participant within 5 to 7 years of their age; while vulvar sensitivity to mechanical stimuli such as touch and pressure declines with menopause , none of our participants had entered menopause. All were menstruating regularly, except for three (one was on the patch continuously, one had undergone Depo‐Provera injections, and one attributed her cycle irregularity to her birth control method).…”