Recommendations for the Study of Vulvar Pain in Women, Part 2: Methodological Challenges

Abstract

IntroductionChronic vulvar pain is a multidimensional condition with great variability in clinical presentation among affected women. In a companion article, part 1, we reviewed and recommended assessment and measurement tools for vulvar pain and related outcomes with a view toward improving consistency and comparison across studies. Yet methodological challenges to conducting research with this population remain and can further hinder conclusions regarding etiology and treatment. AimTo discuss methodological challenges to conducting vulvar pain research alongside recommended solutions. MethodsThe expert authors reviewed the scientific evidence related to the study of vulvar pain and made decisions regarding methodological challenges and mitigation strategies via discussion and consensus. Main Outcome MeasureWe articulated key challenges to conducting research in this area and formulated recommendations for mitigating these challenges. ResultsChallenges to the field include selection and sample biases, heterogeneity of the condition, inclusion of the partner, and neglect of the multidimensional aspects of vulvar pain. 2 key recommendations are more careful and detailed tracking and characterization of research samples and greater multidisciplinary collaboration to better capture the complexity of chronic vulvar pain. Clinical ImplicationsThis methodological critique points to several challenges to clinical research with populations struggling with chronic vulvar pain and makes suggestions for how to mitigate these issues. Strength & LimitationsComments in this expert review raise awareness regarding core challenges to the study of vulvar pain and can inform study design of clinical research with this population. The content of this review is based on expert knowledge and opinion rather than a formal systematic review or extended consultation process. ConclusionA careful reflection upon methodological challenges facing clinical research of vulvar pain and ways to mitigate such challenges is crucial for improving the quality, generalizability, and uptake of research findings.Rosen NO, Bergeron S, Pukall CF. Recommendations for the Study of Vulvar Pain in Women, Part 2: Methodological Challenges. J Sex Med 2020; 17:595–602.