Sensory Neuropeptides, Serotonin Innervations and Personality in Women with Vulvodynia

Abstract

Objective: The pathophysiology of vulvadynia is still unclear. We evaluated the general innervations of the nerves, the sensory neuropeptides in the vestibular area in eighteen women with vulvadynia, aged 20-38. The same individual acted as her own control and biopsies were taken from affected and none affected areas of posterior wall of the vulval vestibule. Quantitative immunohistochemistry was performed, using antisera to the general neuronal marker protein gene product (PGP) 9.5 and to the sensory neuropeptides substance P and calcitonin gene-related peptide (CGRP). Pain and stress assessments were made. Results: The number of PGP 9.5 immunoreactive in the affected areas showed an increase in number (p=0.06) compared to control sites (p=0.40), but the result did not reached to significance. High scores for pain sensation, signs of burnout, emotional and physical symptoms of stress and anxiety were indicated, regardless of time in all women. Conclusions: An increase in PGP 9.5 immunoreactive nerve fibers may be either secondary to nerve sprouting, or may represent neural hyperplasia, which could be applied as an objective diagnostic finding in vulvadynia. Further studies needed for the neuromediator’s roll and inter individual factors for the diagnosis. Vulvodynia seem lead to chronic pain, hence having negative impact on the couple's relationship and the quality of life of women in several ways.