Abstract
Context. Vulvar pain level may fluctuate in women with vulvodynia even in the absence of therapy; however, there is little evidence suggesting which factors may be associated with variability. Objective. Determine the feasibility of using smartphones to collect prospective data on vulvar pain and factors that may influence vulvar pain level. Methods. 24 clinically confirmed women were enrolled from a population-based study and asked to answer five questions using their smartphones each week for one month. Questions assessed vulvar pain level (0–10), presence of pain upon wakening, pain elsewhere in their body, treatment use, and intercourse. Results. Women completed 100% of their scheduled surveys, with acceptability measures highly endorsed. Vulvar pain ratings had a standard deviation within women of 1.6, with greater variation on average among those with higher average pain levels (P < 0.001). On the weeks when a woman reported waking with pain, her vulvar pain level was higher by 1.82 on average (P < 0.001). Overall, average vulvar pain level was not significantly associated with the frequency of reporting other body pains (P = 0.64). Conclusion. Our smartphone tracking system promoted excellent compliance with weekly tracking of factors that are otherwise difficult to recall, some of which were highly associated with vulvar pain level.
Highlights
Chronic vulvar pain affects approximately 8% of the female population under 40 years old in the USA [1], with prevalence increasing to 18% across the lifespan [2]
Among women with severe localized pain, vestibulectomy may be an effective measure for reducing vulvar pain intensity; pain reduction rates with this surgery have not been found to be different from medical management [4]
Most of the literature reporting changes in vulvar pain level has been from clinical trials measuring the effectiveness of a new therapy and tends to compare pain levels between distant times and misses weekly or even daily fluctuation in pain intensity
Summary
Chronic vulvar pain affects approximately 8% of the female population under 40 years old in the USA [1], with prevalence increasing to 18% across the lifespan [2]. In the absence of cures for vulvar pain, the vast majority of women with chronic vulvar pain employ palliative pain measures [5]. It is chronic, some women describe their vulvar pain as intermittent or episodic [2]. Most of the literature reporting changes in vulvar pain level has been from clinical trials measuring the effectiveness of a new therapy and tends to compare pain levels between distant times and misses weekly or even daily fluctuation in pain intensity. Clinical trials generally select women who have sought care and may not reflect the majority of women with chronic vulvar pain who have symptoms but who do not seek care for their pain [7, 8]
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