History of Comorbid Orofacial Pain Among Women with Vulvar Vestibulitis Syndrome

Introduction: • Vestibulodynia is the most common from of chronic vulvovaginal pain affecting nearly 1 in 10 women at some point in their lifetime • The diagnosis of vestibulodynia is diagnosis of “exclusion” in that it is rendered only after excluding other “known causes” of persistent pain upon genital contact (i.e. tampon use) and tenderness to pressure localized within the vulvar mucosa (vestibule) and the etiology and natural history of vestibulodynia remains poorly understood • An emerging body of evidence supports the notion of vestibulodynia as a complex pain disorder of urogenital region • Women with vestibulodynia have higher pain sensitivity on mucosal contact in non-genital sites • Also, these women have a higher prevalence of psychological distress, such as somatization and anxiety • These observations suggest that women with vestibulodynia may have an alteration in pain processing pathways similar to that seen in other pain disorders • We hypothesize that vestibulodynia is a group of disorders characterized by dysfunctions in the vestibular mucosa (i.e., heightened inflammatory response) and central pain processing pathways • In previous work we identified that orofacial pain (OFP) might be a clinical marker for a state of pain amplification among women with vestibulodynia • Co-morbid OFP was highly prevalent in our cohort of vestibulodynia patients • The objective of this study is to examine the stability of OFP symptoms two years after the initial examination while investigating the reliability of our baseline observations on the clinical correlates of comorbid OFP.