(081) The Psychosocial Barriers Associated with Vulvodynia and Vestibulodynia

Abstract

Abstract Introduction At least 8-16% of people with a vulva are affected by generalized vulvodynia and vestibulodynia. These conditions impact interpersonal relationships, individual behaviors, and the psychological health of couples and individuals. Recent reviews suggest there is no comprehensive understanding on how psychosocial factors impact patients with these conditions. Objective The aim of this review is to analyze, evaluate, and synthesize vulvodynia and vestibulodynia research regarding psychosocial barriers present in the literature from 2012-2022 in the United States and Canada. In addition to psychosocial barriers, structural determinants and environmental barriers were included to comprehensively evaluate all aspects. Methods We searched PubMed, CINAHL, Embase, Web of Science, APA PsychInfo, and Academic Search Premier to retrieve eligible journal articles in March of 2022. A search string of key terms and subject headings including Medical Subject Headings were used systematically to search these databases. The reference list was reviewed with an additional reviewer to reduce bias. Results A total of 671 papers were discovered and narrowed down to 74 papers that explored at least one psychosocial barrier for patients or providers in the United States and Canada. The findings of the literature search revealed the various psychosocial barriers that patients commonly face such as pain, anxiety, depression, catastrophization, fear, lack of self-efficacy, low desire and arousal, negative body image, stigma, distress, post-traumatic stress disorder (PTSD), child maltreatment and abuse, mistrust, invalidation and isolation, low levels of self-compassion, negative partner support, low relationship satisfaction, lack of physical affection, emotional regulation, and avoidance and lack of approach goals. In addition to psychosocial barriers, structural determinants, and environmental barriers, such as delayed diagnosis, low health literacy, cost, transportation, and racial disparities also adversely impacted individuals with vulvodynia. Conclusions This review serves to educate and inform providers and physicians of the unique barriers that patients experience when navigating health care services and treatments for vulvodynia and vestibulodynia. More research is needed to understand and better educate patients and providers on vulvar pain conditions to improve outcomes. Disclosure No