Grant: Travel Awards - Institute Community Support

Provoked vestibulodynia (PVD) is characterized by the subjective experience of pain in response to pressure applied around vulvar vestibule. Currently, the assessment and diagnosis of PVD relies on: self-reported pain during vaginal penetration, the absence of an identifiable physiological cause of the pain, and pain elicited during a gynecological examination. Despite the fact that self-reported vulvar pain sensitivity during psychophysical testing distinguishes women with and without PVD, there is some reluctance to rely on subjective pain reporting as diagnostic. Moreover, within the pain literature, self-reported pain ratings are often criticized due to the influence of psychological and emotional factors. Therefore, an examination of pain using a physiological measure (galvanic skin response; GSR) could help to further elucidate the pain experience in women with PVD. The aim of the present study was to investigate whether GSR could be used as an index of pain in women with and without PVD. Results revealed that women with PVD (n = 18) had significantly lower vulvar pain thresholds than women without PVD (n = 18) using two types of vulvalgesiometers. The physiological assessment of pain revealed a significant increase in GSR (relative to baseline) during painful stimulation in both groups of women, providing objective evidence of pain. This study replicated and extends previous research finding that women with PVD have higher self-reported vulvar pain sensitivity than women without PVD, as well as exhibit a physiological response to painful stimuli. Together, these data provides evidence that women's vulvar pain is detectable using both self-report and physiological parameters. Given the utility of GSR as an index of pain, researchers may consider including GSR during their assessment of PVD in order to fully evaluate the pain experience, as well as examining changes in women's experience of pain as a function of treatment.