Persistent Genitopelvic Pain: Classification, Comorbidities, Chronicity, and Interpersonal Factors

Abstract

To review recently published literature on vulvodynia classification, comorbidities, chronicity, and interpersonal factors, and to outline critical gaps between research findings and clinical practice. The classification of vulvodynia varies in terms of its specificity and degree of focus on pain and psychosocial correlates, with recent conceptualizations supporting a biopsychosocial framework. The presence of comorbidities in those with vulvodynia is associated with poorer symptom outcomes and psychosocial wellbeing, as well as longer-term symptom presentation. Longitudinal research has indicated that the course of vulvodynia can vary, with some women experiencing complete pain remission, pain remission with relapse, or pain persistence. There has been a significant increase in psychosocial research in vulvodynia, with much attention on the role of interpersonal factors in the experience of pain and in sexual and relationship satisfaction. Partner dynamics and sexual motivation have figured prominently in this area of research. The field of vulvodynia research has grown exponentially over the past few years, with an increase in attention to factors and issues outside pathophysiological processes in the vulva. Despite empirically-based recommendations for treatment options, treatment algorithms remain inconsistent and are based on poorly supported treatment options.