Abstract
Objective. The aim of the study was to compare the pain symptoms of fibromyalgia patients exhibiting (FMS+PVD) and not exhibiting (FMS) comorbidity with provoked vulvodynia. Study Design. The case control study was performed in 39 patients who had been diagnosed with FMS and accepted to undergo gynaecological examination and in 36 healthy women (C). All patients completed standardized questionnaires for pain intensity, pain area, and psychological functioning. The gynaecological examination included vulvar pain pressure reactivity (Q-tip), pelvic tone assessment (Kegel manoeuver), and a semistructured interview collecting detailed information about pelvic symptoms and sexual function. Results. FMS+PVD patients displayed a higher number of associated symptoms than FMS patients. The vulvar excitability was significantly higher in FMS+PVD than in FMS and in both groups than in Controls. Half of FMS+PVD patients were positive to Kegel manoeuver and displayed higher scores in widespread pain intensity, STAI-Y2, and CESD levels than Kegel negative patients. Conclusions. The study reveals that increased vulvar pain excitability may occur in FMS patients independently of the presence of coital pain. Results suggest that coital pain develops in patients with higher FMS symptoms severity due to the cooperative effects of peripheral and central sensitization mechanisms.
Highlights
Fibromyalgia (FMS) is a condition of chronic widespread musculoskeletal pain characterized by steadily, diffuse, fluctuating musculoskeletal pain associated with hyperreactivity to deep pressure stimuli [1]
Half of FMS+PVD patients were positive to Kegel manoeuver and displayed higher scores in widespread pain intensity, STAI-Y2, and CESD levels than Kegel negative patients
25% of the FMS + PVD patients were aware of the PVD onset: vulvar pain could develop suddenly, gradually, at first intercourse, during pregnancy, or since childhood and could precede or follow the FMS onset
Summary
Fibromyalgia (FMS) is a condition of chronic widespread musculoskeletal pain characterized by steadily, diffuse, fluctuating musculoskeletal pain associated with hyperreactivity to deep pressure stimuli [1]. Several studies have shown that FMS painful areas may include tights, lower back, and the perineum; it is worth noting that these regions are involved in comfortably positioning oneself for sexual intercourse [6, 7]. Genital pain at intercourse may be due to many pelvic conditions such as infections and dermatological, metabolic, autoimmune, or neoplastic diseases; it can be due to a clinical disorder that has been identified as a unique entity, the “burning vulva syndrome,” or vulvovestibular syndrome [11].
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