Basic & Clinical Medicine ›› 2008, Vol. 28 ›› Issue (4): 315-330.

• 专题综述 • Previous Articles     Next Articles

Vulvodynia: A review of pathophysiological factors and treatment options

Caroling F Pukall Sophie Bergeron Corrie Goldfinger   

  1. Queen's University Université du Québec à Montréal and Sex and Couple Therapy Service, Department of Psychology, McGill University Health Centre (Royal Victoria Hospital) Queen's University
  • Received:2008-05-08 Revised:1900-01-01 Online:2008-04-25 Published:2008-04-25
  • Contact: Caroling F Pukall

Abstract: Vulvodynia, or chronic vulvar pain, affects 16% of women in the general population and has negative effects on numerous aspects of a woman's life. The purpose of this paper is to review the literature on the etiology and treatment of vulvodynia. Since relatively little research has been carried out on unprovoked generalized vulvodynia (UGVD), this review focuses on provoked vestibulodynia (PVD), a subtype of vulvodynia characterized by a severe, burning/sharp pain that occurs in response to pressure localized to the vestibule. Research examining the pathophysiology of PVD provides evidence that both peripheral (e.g., vestibular tissue abnormalities, pelvic floor hypertonicity) and central (e.g., increased neural activation) factors are involved in the development and maintenance of PVD. Additionally, psychological reactions to the pain may vary and influence the expression and course of the pain. Despite the multitude of factors involved in PVD, most treatment studies to date are unimodal in nature, retrospective, and uncontrolled. A review of treatment studies targeting peripheral (e.g., topical applications, vestibulectomy) and central (e.g., antidepressants, pain management therapy) components of PVD is provided, and the need for multimodal treatment plans which target both levels of pain processing is discussed. Given the complexity of PVD, a biopsychosocial approach is recommended for future research endeavors and treatment plans.