Health seeking behaviours and treatments received by Australian women with vulvodynia: A cross-sectional survey.

Alice M Mitchell,K Jane Chalmers,Mike Armour

doi:10.1111/ajo.13423

Abstract

Vulvodynia is a condition characterised by pain in the vulva lasting more than three months and for which no obvious aetiology can be found. It affects around 8% of women and has significant negative impacts on quality of life. There is a paucity of research on healthcare management pathways and the use of evidence-based treatments in an Australian community setting. To explore which healthcare professionals Australian women with vulvodynia seek treatment from, and which treatments are recommended, provided, or prescribed by these healthcare professionals. A cross-sectional online survey was conducted from May 2019 to August 2019. Women were eligible to participate if they had been diagnosed with vulvodynia by a healthcare professional, were currently living in Australia, and were over 18years old. Fifty respondents meet the inclusion criteria, with a mean age of 30.5years. On average, respondents reported seeing four different types of healthcare professionals in the management of their vulvodynia, with general practitioners (GPs) (98%), medical specialists (96%), and physiotherapists (80%) being the three most commonly consulted. Most respondents reported seeing multiple GPs (>87%), multiple medical specialists (>77%), and multiple physiotherapists (50%). The most commonly prescribed interventions were pelvic floor down-training exercises (76%), topical (70%) and oral (70%) medication, and vulvodynia information (56%). Australian women with vulvodynia seek help from several professionals and receive a variety of treatments for their pain. Of concern is many treatments that are being offered clinically have very little peer-reviewed evidence of effectiveness in vulvodynia.

Highlights

Vulvodynia is a disorder defined by the International Society for the Study of Vulvovaginal Diseases as chronic pain or discomfort of the vulva lasting more than three months and for which no obvious aetiology can be found.[1]
Women were eligible to participate if they had been diagnosed with vulvodynia by a healthcare professional, were currently living in Australia, and were over 18 years old
Women were eligible to participate in the survey if they were aged over 18 years, were currently living in Australia, and had a current diagnosis of vulvodynia from a medical or health professional

Summary

Introduction

Vulvodynia is a disorder defined by the International Society for the Study of Vulvovaginal Diseases as chronic pain or discomfort of the vulva lasting more than three months and for which no obvious aetiology can be found.[1]. Due to the disparity in vulvodynia presentations, not all treatment approaches will be beneficial for all patients,[7] and women often seek help from multiple healthcare professionals with little success in symptom reduction.[3,4,5,6, 8] Results from a questionnaire study from Boston MA, USA, found that more than 60% of women with a history of unexplained chronic vulvar pain consulted with three or more different clinicians, and greater than 30% of respondents whose pain impacted on sexual intercourse visited more than five doctors.[9] This disjointed nature to assessment and treatment creates significant delays to effective management. There is a paucity of research on healthcare management pathways and the use of evidence-based treatments in an Australian community setting

Methods

Results

Conclusion