Vulvar pain - Psychological profiles and treatment responses

OBJECTIVE: To compare the psychological and quality of life profiles of wom en with different subsets of vulvodynia and identify differential response patterns to a combined gynecolog-dermatologic treatment program. STUDY DESIGN: Fifty-three women with vulvar dermatoses, dysethetic vulvodyn ia and vulvar vestibulitis were recruited from a combined dermatologic and gynecologic vulvar clinic and completed instruments related to quality of l ife (QoL) and psychologic symptomatology. A repeated measurement design was employed. However, only 33 women could be assessed at the second point of measurement. RESULTS: Women with different subsets of vulvodynia showed (1) distinct qua lity of life and psychological profiles, and (2) different response pattern s to treatment. There were significant differences on most QoL scales, with patients with dysesthetic vulvodynia and with vulvar dermatoses showing gr eater impairment than patients with vestibulitis. However, patients with ve stibulitis displayed a highly specific pattern of psychologic symptomatolog y. Patients with vulvar dermatoses had an improvement in problems related t o intimacy than patients with vulvar pain syndromes. CONCLUSION: Treatment intervention studies seem to be indispensible in orde r to gain a better understanding of the complex interplay between different subsets of vulvodynia and psychological symptoms concurrently with differe ntial treatment reactions. (J Reprod Med 2001; 46:377-384).