An estimated 10 million women suffer from chronic pelvic pain. While less than 70% receive a proper diagnosis, it’s estimated another 61% remain undiagnosed. This discrepancy in patient care led the International Society for the Study of Vulvovaginal Disease (ISSVD), International Society for the Study of Women’s Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS) to meet in 2015 to redefine vulva and vaginal pain in a new classification system to improve diagnosis and treatment.
The meeting’s success resulted in a new definition for vulvodynia: “Vulvodynia is not one disease, but a constellation of symptoms of several (sometimes overlapping) disease processes, which will benefit best from a range of treatments based on individual presentations.”
Present at the 2015 meeting, author Stephanie Prendergast, MPT, suggests that gynecology exams which could include a screening of the pelvic floor muscles and tissues may be useful in identifying musculoskeletal dysfunction. With this basic assessment, healthcare providers could then recommend patients for pelvic floor examinations for further diagnosis and treatment.
In her article, Prendergast provides a physical therapy evaluation guide to assist pelvic floor therapists with assessment, evaluation, and treatment plans, and suggests that because of the heterogeneous nature of vulvodynia, properly addressing each patient’s vulvodynia may include multimodal therapies.
Prendergast’s article concludes that successful measures to address pelvic pain begin with a proactive stance and evaluation of vaginal care concerns.
(Obstetrics and Gynecology Clinics of North America, September 2017)