Lester Robynn A, Brotto Lori A, Sadownik Leslie A
Faculty of Medicine, University of British Columbia, Vancouver BC.
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
J Obstet Gynaecol Can. 2015 Nov;37(11):995-1005. doi: 10.1016/s1701-2163(16)30049-4.
Sexual pain secondary to provoked vestibulodynia (PVD) is a chronic pain condition affecting up to 16% of women. Women with PVD may report other chronic pain conditions. The goals of this study were (1) to identify the prevalence of self-reported chronic pain conditions in a sample of women with a diagnosis of PVD and seeking treatment, and (2) to compare demographic and clinical characteristics and health care needs of women with PVD alone and women with PVD and two or more self-reported chronic pain conditions.
We assessed the characteristics of 236 women with PVD alone and 55 women with PVD and comorbid chronic pain using a standardized questionnaire, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Pain Vigilance and Awareness Questionnaire, and the Female Sexual Distress Scale.
Compared with women with PVD alone, women with PVD and other concurrent pain reported a significantly longer duration of pain, pain radiating to other parts of the vulva, and pain interfering in a variety of daily activities. This group was also significantly more likely to have seen more gynaecologists, and to have had more office visits with their gynaecologist than women with PVD alone. They were more likely to have tried anticonvulsants, antidepressants, and stress/relaxation therapy for their PVD and were also more likely to have allergies and skin sensitivities. Finally, this group of women had higher symptoms of depression, trait anxiety, and showed a trend towards more pain vigilance.
Taken together, these findings suggest that physicians caring for women with PVD and concurrent chronic pain must be alert to the potentially greater health needs among this subsample of women.
由激发性前庭痛(PVD)继发的性交疼痛是一种慢性疼痛疾病,影响着多达16%的女性。患有PVD的女性可能还患有其他慢性疼痛疾病。本研究的目的是:(1)确定在已确诊PVD并寻求治疗的女性样本中自我报告的慢性疼痛疾病的患病率;(2)比较单纯患有PVD的女性与患有PVD且自我报告有两种或更多慢性疼痛疾病的女性的人口统计学和临床特征以及医疗保健需求。
我们使用标准化问卷、贝克抑郁量表、状态-特质焦虑量表、疼痛警觉与意识问卷以及女性性困扰量表,评估了236名单纯患有PVD的女性和55名患有PVD且伴有慢性疼痛的女性的特征。
与单纯患有PVD的女性相比,患有PVD及其他并发疼痛的女性报告疼痛持续时间显著更长,疼痛放射至外阴其他部位,且疼痛干扰了各种日常活动。与单纯患有PVD的女性相比,该组女性看妇科医生的次数显著更多,与妇科医生的门诊就诊次数也更多。她们更有可能尝试使用抗惊厥药、抗抑郁药以及针对PVD的压力/放松疗法,也更有可能有过敏和皮肤敏感问题。最后,这组女性的抑郁症状、特质焦虑症状更高,且表现出疼痛警觉性更高的趋势。
综上所述,这些发现表明,照顾患有PVD及并发慢性疼痛的女性的医生必须警惕这部分女性潜在的更大的健康需求。