Why we study PVD (provoked vestibulodynia)

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Image Credit: Flick user Ben Raynal

By Maria Glowacka

We have exceptional health services in Nova Scotia for women. Still, some health problems that affect women’s physical and sexual health can be neglected due to misinformation and a lack of research to inform better treatment options. One such condition is provoked vestibulodynia (PVD). This pain condition is characterized by chronic pain in the vulvar vestibule that is elicited when there is pressure applied to the area. It affects 7 to 12% of women in community samples 1,2. This translates to approximately 33, 672 to 57, 724 Nova Scotian women who may suffer from this pain condition3.

Although this is a common women’s health problem which negatively affects the overall quality of life of women and their partners4, some women do not receive the medical attention that they require and deserve. Research has found that women with vulvar pain conditions visit on average five physicians before receiving a diagnosis5. A recent study found that half of women do not seek medical care for their chronic vulvar pain6. Both women who sought treatment and those who did not reported that they perceived negative stereotyping from doctors and other health professionals. Women with vulvar pain have difficulty discussing their pain with others and report feelings of shame and invalidation because of their pain condition. Together, these findings highlight the need to improve health professionals’ knowledge of this women’s pain condition as well as the factors associated with its negative sequel.

PVD adversely affects women’s sexual, relationship, and psychological functioning7. Women with PVD experience disruptions to all aspects of their sexual functioning, heightened anxiety and depression, lower self-esteem, and report feelings of shame, isolation, and embarrassment compared to women who do not have this pain condition7. As a result of the intimate nature of this pain, affected women also have difficulties in their romantic relationships. For example, women have reported feeling inadequate as a romantic partner and have described fears of losing or disappointing their partners because of their PVD8,9. Partners of women with PVD also experience negative consequences, such as poorer sexual functioning10,11,12. Since both members of the couple are affected, PVD is undeniably a family issue.

In the Couples and Sexual Health Laboratory, we look at sexuality from a couple’s perspective in order to improve wellbeing, relationships, and treatment options. We are dedicated to determining what factors lead to better outcomes for couples that suffer from PVD and subsequently incorporating our findings into evidence-based treatments. There is currently a lack of psychological treatment for PVD in Nova Scotia, and no empirically supported treatment options that include both members of the couple. We want to change that! Our research aims to improve the health and quality of life of many Nova Scotian couples that may be suffering from a highly prevalent but neglected women’s health problem.

 

REFERENCES

  1. Harlow, B. L., Kunitz, C. G., Nguyen, R. H. N., Rydell, S. A., Turner, R. M., & MacLehose, R. F. (2014). Prevalence of symptoms consistent with a diagnosis of vulvodynia: Population-based estimates from 2 geographic regions American Journal of Obstetrics and Gynecology, 210(1), 40.e41-40.e48. doi: 10.1016/j.ajog.2013.09.033
  2. Moyal-Barracco, M., & Lynch, P. J. (2004). 2003 ISSVD terminology and classification of vulvodynia: A historical perspective. Journal of Reproductive Medicine, 49, 772-779. doi: 35400012060043.0010
  3. Statistics Canada. (2015). Population by marital status and sex, by province and territory (Newfoundland and Labrador, Prince Edward Island, Nova Scotia, New Brunswick). Retrieved Dec 30, 2015, from http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/famil01a-eng.htm
  4.  Arnold, L. D., Bachmann, G. A., Kelly, S., Rosen, R., & Rhoads, G. G. (2006). Vulvodynia: Characteristics and associations with comorbidities and quality of life. Obstetrics and Gynecology, 107, 617-624. doi: 10.1097/01.AOG.0000199951.26822.27
  5. Nguyen, R. H. N., Ecklund, A. M., MacLehose, R. F., Veasley, C., & Harlow, B. L. (2012). Co-morbid pain conditions and feelings of invalidation and isolation among women with vulvodynia. Psychology, Health & Medicine, 17(5), 589-598. doi: 10.1080/13548506.2011.647703
  6. Nguyen, R. H. N., Turner, R. M., Rydell, S. A., MacLehose, R. F., & Harlow, B. L. (2013). Perceived stereotyping and seeking care for chronic vulvar pain. Pain Medicine, 14(10), 1461-1467. doi: 10.1111/pme.12151
  7. Desrochers, G., Bergeron, S., Landry, T., & Jodoin, M. (2008). Do psychosexual factors play a role in the etiology of provoked vestibulodynia? A critical review. Journal of Sex and Marital Therapy, 34, 198-226. doi: 10.1080/00926230701866083
  8. Christopher, F. S., & Sprecher, S. (2000). Sexuality in marriage, dating, and other relationships: A decade review. Journal of Marriage and the Family, 62, 999-1017. doi: 10.1111/j.1741-3737.2000.00999.x
  9. Sheppard, C., Hallam-Jones, R., & Wylie, K. (2008). Why have you both come? Emotional, relationship, sexual and social issues raised by heterosexual couples seeking sexual therapy (in women referred to a sexual difficulties clinic with a history of vulval pain). Sexual and Relationship Therapy, 23(3), 217-226. doi: 10.1080/14681990802227974
  10. Jodoin, M., Bergeron, S., Khalifé, S., Dupuis, Desrochers, G., & Leclerc, B. (2008). Male partners of women with provoked vestibulodynia: Attributions for pain and their implications for dyadic adjustment, sexual satisfaction, and psychological distress. The Journal of Sexual Medicine, 5(12), 2862-2870. doi: 10.1111/j.1743-6109.2008.00950.x
  11. Pazmany, E., Bergeron, S., Verhaeghe, J., Oudenhove, L. V., & Enzlin, P. (2015). Dyadic sexual communication in pre-menopausal women with self-reported dyspareunia and their partners: Associations with sexual function, sexual distress and dyadic adjustment. Journal of Sexual Medicine, 12(2), 516-528. doi: 10.1111/jsm.12787
  12. Rosen, N. O., Bergeron, S., Sadikaj, G., Glowacka, M., Baxter, M. L., & Delisle, I. (2013). Impact of male partner responses on sexual function in women with vulvodynia and their partners: A dyadic daily experience study. Health Psychology, 33(8), 823-831. doi: 10.1037/a0034550