Child Abuse Research Today is a free monthly online journal that collates and summarizes the latest research about Child Abuse, including details on family violence, examinations, long-term effects, psychiatrics disorders.

Life events in patients with vulvodynia.

Plante AF, Kamm MA

Department of Gastroenterology, St Mark's Hospital, London, UK

OBJECTIVE: Vulval pain, in the absence of pathology, may have a psychological basis that relates to life events. This study aimed to determine the nature of such events. DESIGN: Structured questionnaire about patient's symptoms and early-life events. SETTING: Private practice physiotherapist specialising in pelvic floor disorders. POPULATION: Patients with vulvodynia as their primary symptom and control patients being treated for urinary tract disorder or post-childbirth routine physiotherapy who had no vulval pain on direct questioning. METHODS: Questionnaire applied to consecutive patients referred for treatment. Seventy-eight consecutive women presenting with vulvodynia (mean age 34 years, mean duration of symptoms 48 months) and 78 controls (mean age 39 years). MAIN OUTCOME MEASURES: Incidence of life events. RESULTS: A similar proportion of both groups were married. Being in a new relationship (P < 0.04), adverse current or previous relationships (39 versus 9%, P < or = 0.01), parental divorce (26 versus 9%, P < or = 0.001), history of termination of pregnancy, and adverse childbirth experiences (P < 0.04) were more common in patients than in controls. A history of sexual abuse was not more common in patients with vulvodynia compared with controls (13 versus 10%, P = not significant). Lack of libido was common in patients with vulvodynia (94 versus 29%, P < 0.0001). CONCLUSIONS: Adverse life experiences, including conflict, are common in women with vulvodynia. These factors may be important in mediating the genesis of pain through stress-related mechanisms. Sexual interest is diminished in these women. Sexual abuse is not a factor in most of these women. These findings have implications for treatment.

Published 14 February 2008 in BJOG, 115(4): 509-14.
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