Overlap Between Orofacial Pain and Vulvar Vestibulitis Syndrome

Abstract

Objectives-To explore the prevalence of Orofacial Pain (OFP) among patients with Vulvar Vestibulitis Syndrome (VVS) and to examine the relationship between signs and symptoms of OFP and clinical characteristics of women with VVS; we specifically sought to investigate differences in psychological characteristics and self-reported severity of painful intercourse.Methods-In this cross-sectional exploratory study, 137 women with VVS completed questionnaires that assessed self-reported levels of pain, anxiety, somatization, and presence of signs and symptoms suggestive of clinical and sub-clinical OFP. Demographic data were gathered from medical records. Results-OrofacialPain was found to be a highly prevalent (78%) condition among women with VVS. Compared to women with no OFP symptoms (n=30), those with symptoms (n=64) had higher levels of anxiety (45.0 vs. 37.8, Bonferroni adjusted p=0.017), somatization (125.2 vs. 96.0, Bonferroni adjusted p<0.001), and psychological distress (62.8 vs. 56.0, Bonferroni adjusted p=0.002). While we observed a similar trend among women with sub-clinical OFP (n=43), this trend only reached statistical significance with respect to somatization. Differences were not detected for demographics, duration of pain, and severity of pain during intercourse across the three groups.Discussion-Orofacial Pain is a common condition among women with VVS. Because severity and duration of painful intercourse did not differ by OFP classification but psychological characteristics did, we must begin to question a uni-dimensional focus on vestibular mucosa as a reason for pain and persistent distress.

Decreased concentration of protease inhibitors: possible contributors to allodynia and hyperalgesia in women with vestibulodynia

“…[14][15][16][17] Some women with vestibulodynia also report enhanced pain responses in other areas of their body. 18 It remains to be determined whether there is a genetic basis for a decreased concentration of protease inhibitors in a subset of these women and whether this contributes to generalized as well as localized increased pain sensitivity.…”

Psychosexual correlates of persistent postsurgical pain in patients with vulvodynia

“…Vaginal pain was measured by the Gracely pain scale [5], which asks patients to self-report their lowest, average, and maximal vaginal pain on a scale of 0 to 100 [6]. Note that the pain ratings and psychologic scores were ascertained retrospectively; there are no data on the participants’ pain ratings or psychologic scores prior to surgery.…”

Urogenital Symptoms and Pain History as Precursors of Vulvodynia: A Longitudinal Study

“…1,6,[8][9][10][11] However, the cross-sectional study design does not allow differentiation between those symptoms that are precursors to vs. comorbid with vulvodynia. Few prospective data are available.…”