A 2020 study published in Sexual Medicine (journal of The International Society of Sexual Medicine) examined the prevalence of “pain-related anxiety and depression” in women with provoked vestibulodynia with associated overactive pelvic floor muscle dysfunction (PVD-PFD).
Vulvodynia is a chronic pain condition of the vulva that affects as many as 16% of women in the U.S. at some point in their life. Those diagnosed with vulvodynia are more likely to experience psychological distress; it is also well reported that vulvodynia can be present in women with a history of pre-existing anxiety and/or depression.
This study’s particular aim, however, was to measure the pervasiveness of pain-related anxiety and depression in patients suffering from PVD-PFD. Women included in the study were diagnosed with a combination of symptoms: dyspareunia, provoked pain, and overactive pelvic floor muscle dysfunction. Data was also assessed using a Pain Anxiety Symptoms Scale and a questionnaire evaluating depressing and anxiety. Results from the study demonstrated a statistically significant association between anxiety and depression in women with PVD-PDF.
Understanding the dominance of pain-related anxiety and depression in women with PVD-PFD is the first and most important step for determining treatment, the study concluded. Pain-related anxiety further exacerbates the pain cycle and promotes a fear-anxiety-avoidance cycle, which can lead to chronic pain development. Recommended treatment plans for PVD-PFD should include a multidisciplinary approach, which may include psychological interventions, such as cognitive behavioral therapy, pelvic floor relaxation, and pelvic floor physical therapy.
Exploring Pain-Related Anxiety and Depression in Female Patients With Provoked Vulvodynia With Associated Overactive Pelvic Floor Muscle Dysfunction
Vaishnavi Govind, MS; Jill M. Krapf, MD, MEd; Leia Mitchell, MS; Karissa Barela, MS; Hillary Tolson, BS; Jaqueline Casey, CNA; Andrew T. Goldstein, MD
Journal of Sexual Medicine, June 2020