Mindfulness-based Group Therapy for Women with Provoked Vestibulodynia

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Provoked vestibulodynia (PVD) is the most common cause of painful intercourse in women of reproductive age and research supports psychological approaches in the management of chronic pain. We developed a four-session group treatment for women with PVD that relied mostly on mindfulness meditation skills along with education and some discussion of cognitive theory. A total of 85 women were assigned either to immediate treatment (n = 62; mean age, 39 years) or to a 3-month wait-list condition followed by treatment (n = 23; mean age, 40 years). Questionnaires and a genital pain assessment were administered at pre- and post-treatment, and at 6 months follow-up. Women assigned to the two groups did not significantly differ on any measure at baseline. During the pretreatment wait-list period, there were significant improvements in pain self-efficacy, and non-significant improvements in feelings of helplessness, and sex-related distress. Pain self-efficacy, pain catastrophizing, genital pain induced by a cotton swab exam, pain hypervigilance, and sex-related distress all improved with treatment. There was no change in pain with intercourse. Pretreatment genital pain was the best predictor of post-treatment genital pain. Genital pain at 6-month follow-up was predicted by pretreatment genital pain, change in pain self-efficacy, and number of comorbid chronic pain conditions. Taken together, these findings support the use of a brief mindfulness-based program as a promising treatment for distressing genital pain.