Vulvar pain. Psychological profiles and treatment responses.

Objective: To compare the psychological and quality of life profiles of women with different subsets of vulvodynia and identify differential response patterns to a combined gynecologic-dermatologic treatment program.
Study Design: Fifty-three women with vulvar dermatoses, dysesthetic vulvodynia and vulvar vestibulitis were recruited from a combined dermatologic and gynecologic vulvar clinic and completed instruments related to quality of life (QoL) and psychologic symptomatology. A repeated measurement design was employed. However, only 33 women could be assessed at the second point of measurement.
Results: Women with different subsets of vulvodynia showed (1) distinct quality of life and psychological profiles, and (2) different response patterns to treatment. There were significant differences on most QoL scales, with patients with dysesthetic vulvodynia and with vulvar dermatoses showing greater impairment than patients with vestibulitis. However, patients with vestibulitis displayed a highly specific pattern of psychologic symptomatology. Patients with vulvar dermatoses had an improvement in problems related to intimacy than patients with vulvar pain syndromes.
Conclusion: Treatment intervention studies seem to be indispensable in order to gain a better understanding of the complex interplay between different subsets of vulvodynia and psychological symptoms concurrently with differential treatment reactions.