Grant: Operating Grant

The central theme guiding our research is the investigation of the pain component of vulvodynia (i.e., chronic genital pain in women) within a multidisciplinary pain perspective. Our pain-centered approach has led to unique studies in the area of vulvodynia, including its evaluation and treatment; our approach involves a careful characterization of the pain, an examination of the effects of the pain on functioning, and an investigation of potential physical factors involved in the development and maintenance of vulvodynia. Based on these and other recent studies, various subtypes of vulvodynia have emerged. The most common subtype of vulvodynia is provoked vestibulodynia (PVD); it affects 15% of women. PVD is characterized by a severe burning pain in response to pressure at the vaginal entrance. Affected women report increased psychosocial distress and decreased quality of life as compared to non-affected women; however, very few studies have examined differences within the PVD group based on whether the condition is primary (PVD1; pain that has always existed) or secondary (PVD2; pain that developed after a period of pain-free functioning). Emerging evidence suggests that women with PVD1 and PVD2 differ on factors such as medical history, pain characteristics, and treatment response, with women with PVD1 faring worse than women with PVD2 on all studied variables. These differences have led several authors to propose that PVD1 and PVD2 result from different etiological pathways. We propose to examine PVD1 and PVD2 via an integrated pain approach involving psychosocial, psychophysical, and physiological measures in order to ultimately guide assessment and treatment options to ensure the health and well-being of women with vulvodynia.