Grant: Operating Grant

Provoked vestibulodynia (PVD), or pain at the opening of the vagina with any kind of touch, affects approximately 16% of otherwise healthy women. The most common treatment involves medical management with less than half of women improving. Most women seek help from a variety of different providers for years before experiencing any improvement in their pain. Women with PVD commonly experience a decline in their sexual health, relationship satisfaction, and emotional well-being as a result of frequent painful intercourse or attempts at gynaecologic exams. Thus, psychological approaches that address the genital pain, in addition to these other domains of the woman's life, are very much needed. One previous study found that cognitive behavioural therapy (CBT) administered in groups over 10 sessions significantly reduces genital pain and improves different domains of quality of life. Over the past 10 years, the PI has developed a psychological treatment that integrates skills in mindfulness meditation, cognitive therapy (challenging unhelpful or maladaptive thoughts), and behavioural skills (e.g., muscle relaxation) for women with sexual desire and arousal disorders and found significant improvements on most measures of sexual response and quality of life. We have recently adapted this treatment for women with PVD and have pilot tested it in a small group of 33 women with PVD. In our pilot work, we found that four 90 minute sessions significantly decreased pain and improved measures of sexual health and mood. The goal of this study is to expand the program to 8 sessions, and to compare it to the previously tested CBT (which does not include mindfulness meditation). If found effective, the findings from this study will be used to assist ob/gyns and family doctors who are usually the first point of contact for women seeking treatment for distressing genital pain. We also have future plans to make our treatment available online to reach geographically remote women.