Pain, Anxiety, Depression, and Quality of Life in Patients with Vulvodynia

Abstract

Background/Aims: The term vulvodynia refers to vulvar pain of unknown origin lasting at least 3 months. Psychiatric comorbidities are a common feature and, along with pain, may severely affect patients' wellbeing. We aimed to determine the characteristics of pain in vulvodynia, to correlate characteristics with symptoms of anxiety and depression, and to analyse the impact of these factors on patients' quality of life. Methods: This cross-sectional observational study analysed pain, anxiety, and depression and the effects of these factors on quality of life. Pain, anxiety, and depression were assessed using validated tools in 110 women. Results: Statistical analyses found correlations between pain and anxiety and between anxiety and worsened quality of life. Patients often reported stinging, burning, pain, itching, and dyspareunia, pointing to the importance of temporal, localisation, punctate pressure, thermal, tactile sensitivity, and emotional tension characteristics. Most patients had severe pain related to psychiatric comorbidities and decreased quality of life. Conclusion: Using descriptors of pain quality and assessing anxiety and depression might help to define subgroups of patients that may benefit from different therapeutic approaches and thus enable treatments to be tailored to individual patients. © 2019 S. Karger AG, Basel Key MessageVulvodynia causes severe pain related to anxiety and depression, and a decreased quality of life.

Chronic Vulvar Pain and Health-Related Quality of Life in Women with Vulvodynia

“…The women surveyed scored the highest scores in the psychological and environmental domains of the WHOQoL-BREF questionnaire. Although the women surveyed scored the highest in the psychological domain, some studies show that women with vulvodynia suffer from anxiety and depression [ 56 , 57 ]. In a Spanish study by Tribó et al [ 56 ], 61.7% of vulvodynia patients reported suffering from anxiety and 24.7% were depressed.…”

Female Sexual Dysfunctions and Urogynecological Complaints: A Narrative Review

“…The pain does not only affect sexual function and satisfaction [ 66 ], but is also associated with psychological distress [ 67 , 68 ], relational dissatisfaction, and a lower quality of life [ 59 ]. Yet, it is a neglected pain condition [ 69 ], and many women are left without correct diagnosis and treatment [ 70 ]. Other typical symptoms include allodynia within the vulvar vestibule for at least 3 to 6 months and erythema at the inferior introital sulcus, medial to the Hart line, particularly in the periosteal areas of the vestibular glands [ 62 , 63 ].…”

“…Women with vulvar vestibulitis syndrome are homozygous for allele 2 of the IL-1RA gene (IL1RN*2), a phenotype linked to ulcerative colitis, Crohn’s disease, and systemic lupus erythematosus, according to one explanation. Proinflammatory reactions are more protracted and intense in persons with this phenotype than in those with other IL-1RA genotypes [ 70 ]. Another notion is that unpleasant environmental stimuli cause neurogenic inflammation of the vulvar vestibule ”end-organ,” resulting in parasympathetic efferent and visceral nociceptive afferent hyperactivity.…”

Acid-sensing ion channel 1a in the central nucleus of the amygdala regulates anxiety-like behaviors in a mouse model of acute pain

“…The link between pain and anxiety has proven to be increasingly significant, and both act as risk factors for each other. Multiple lines of evidence have shown that clinically, patients suffering from pain also experience anxiety ( Michaelides and Zis, 2019 ; Tribo et al, 2020 ). Proper clinical treatment for comorbid anxiety symptoms in pain (CASP) is a significant challenge since the mechanism is not fully understood.…”