Women's Sexual Pain Disorders
Jacques J.D.M. Van Lankveld PhD,
Michal Granot PhD,
Willibrord C.M. Weijmar Schultz MD, PhD,
Yitzchak M. Binik PhD,
Ursula Wesselmann MD, PhD,
Caroline F. Pukall PhD,
Nina Bohm-Starke MD, PhD,
Chahin Achtrari MD, PhD,
Corresponding Author
Jacques J.D.M. Van Lankveld PhD
Maastricht University, Clinical Psychological Science, Maastricht, The Netherlands;
Jacques JDM van Lankveld, PhD, Department of Clinical Psychological Science, Maastricht University, Universiteitssingel 40, 6200 MD Maastricht, Netherlands. Tel: (31) 43-3881047; Fax: (31) 43-3884196; E-mail: [email protected]Search for more papers by this authorMichal Granot PhD
University of Haifa Faculty of Welfare and Health Sciences, Nursing, Haifa, Israel;
Search for more papers by this authorWillibrord C.M. Weijmar Schultz MD, PhD
University Hospital Groningen, University Medical Center Groningen, Obstetrics & Gynecology, Groningen, The Netherlands;
Search for more papers by this authorYitzchak M. Binik PhD
McGill University & Sex and Couple Therapy Service, Psychology, McGill University Health Center, Montreal, Quebec, Canada;
Search for more papers by this authorUrsula Wesselmann MD, PhD
University of Alabama at Birmingham, Anesthesiology/Pain Management, Birmingham, AL, USA;
Search for more papers by this authorCaroline F. Pukall PhD
Queen's University, Psychology, Kingston, Ontario, Canada;
Search for more papers by this authorNina Bohm-Starke MD, PhD
Karolinska Institutet, Clinical Sciences Division of Obstetrics & Gynecology, Danderyd Hospital, Stockholm, Sweden;
Search for more papers by this authorChahin Achtrari MD, PhD
CHUV, Gynécologie, Lausanne, Switzerland
Search for more papers by this authorJacques J.D.M. Van Lankveld PhD,
Michal Granot PhD,
Willibrord C.M. Weijmar Schultz MD, PhD,
Yitzchak M. Binik PhD,
Ursula Wesselmann MD, PhD,
Caroline F. Pukall PhD,
Nina Bohm-Starke MD, PhD,
Chahin Achtrari MD, PhD,
Corresponding Author
Jacques J.D.M. Van Lankveld PhD
Maastricht University, Clinical Psychological Science, Maastricht, The Netherlands;
Jacques JDM van Lankveld, PhD, Department of Clinical Psychological Science, Maastricht University, Universiteitssingel 40, 6200 MD Maastricht, Netherlands. Tel: (31) 43-3881047; Fax: (31) 43-3884196; E-mail: [email protected]Search for more papers by this authorMichal Granot PhD
University of Haifa Faculty of Welfare and Health Sciences, Nursing, Haifa, Israel;
Search for more papers by this authorWillibrord C.M. Weijmar Schultz MD, PhD
University Hospital Groningen, University Medical Center Groningen, Obstetrics & Gynecology, Groningen, The Netherlands;
Search for more papers by this authorYitzchak M. Binik PhD
McGill University & Sex and Couple Therapy Service, Psychology, McGill University Health Center, Montreal, Quebec, Canada;
Search for more papers by this authorUrsula Wesselmann MD, PhD
University of Alabama at Birmingham, Anesthesiology/Pain Management, Birmingham, AL, USA;
Search for more papers by this authorCaroline F. Pukall PhD
Queen's University, Psychology, Kingston, Ontario, Canada;
Search for more papers by this authorNina Bohm-Starke MD, PhD
Karolinska Institutet, Clinical Sciences Division of Obstetrics & Gynecology, Danderyd Hospital, Stockholm, Sweden;
Search for more papers by this authorChahin Achtrari MD, PhD
CHUV, Gynécologie, Lausanne, Switzerland
Search for more papers by this authorABSTRACT
Introduction. Women's sexual pain disorders include dyspareunia and vaginismus and there is need for state-of-the-art information in this area.
Aim. To update the scientific evidence published in 2004, from the 2nd International Consultation on Sexual Medicine pertaining to the diagnosis and treatment of women's sexual pain disorders.
Methods. An expert committee, invited from six countries by the 3rd International Consultation, was comprised of eight researchers and clinicians from biological and social science disciplines, for the purpose of reviewing and grading the scientific evidence on nosology, etiology, diagnosis, and treatment of women's sexual pain disorders.
Main Outcome Measure. Expert opinion was based on grading of evidence-based medical literature, extensive internal committee discussion, public presentation, and debate.
Results. A comprehensive assessment of medical, sexual, and psychosocial history is recommended for diagnosis and management. Indications for general and focused pelvic genital examination are identified. Evidence-based recommendations for assessment of women's sexual pain disorders are reviewed. An evidence-based approach to management of these disorders is provided.
Conclusions. Continued efforts are warranted to conduct research and scientific reporting on the optimal assessment and management of women's sexual pain disorders, including multidisciplinary approaches. van Lankveld JJDM, Granot M, Weijmar Schultz WCM, Binik YM, Wesselmann U, Pukall CF, Bohm-Starke N, and Achtrari C. Women's sexual pain disorders. J Sex Med 2010;7:615–631.
References
- 1 Moyal-Barracco M, Lynch PJ. 2003 ISSVD terminology and classification of vulvodynia: A historical perspective. J Reprod Med 2004; 49: 772–7.
- 2 Sims MJ. On vaginismus. Transcr Obstet Soc Lond 1861; 3: 356–67.
- 3 Binik YM. Dyspareunia looks sexy on first but how much pain will it take for it to score? A reply to my critics concerning the DSM classification of dyspareunia as a sexual dysfunction. Arch Sex Behav 2005; 34: 63–7.
- 4 Van Lankveld JJ, Ter Kuile MM, De Groot HE, Melles R, Nefs J, Zandbergen M. Cognitive-behavioral therapy for women with lifelong vaginismus: A randomized waiting-list controlled trial of efficacy. J Consult Clin Psychol 2006; 74: 168–78.
- 5 Shafik A, Doss S. Surgical anatomy of the somatic terminal innervation to the anal and urethral sphincters: Role in anal and urethral surgery. J Urol 1999; 161: 85–9.
- 6 Hilliges M, Falconer C, Ekman-Ordeberg G, Johansson O. Innervation of the human vaginal mucosa as revealed by PGP 9.5 immunohistochemistry. Acta Anat (Basel) 1995; 153: 119–26.
- 7 Krantz KE. Innervation of the human vulva and vagina; a microscopic study. Obstet Gynecol 1958; 12: 382–96.
- 8 Weijmar Schultz WC, Van De Wiel HB, Klatter JA, Sturm BE, Nauta J. Vaginal sensitivity to electric stimuli: Theoretical and practical implications. Arch Sex Behav 1989; 18: 87–95.
- 9 Komisaruk BR, Whipple B. Functional MRI of the brain during orgasm in women. Annu Rev Sex Res 2005; 16: 62–86.
- 10 Berkley KJ, Benoist JM, Gautron M, Guilbaud G. Responses of neurons in the caudal intralaminar thalamic complex of the rat to stimulation of the uterus, vagina, cervix, colon and skin. Brain Res 1995; 695: 92–5.
- 11 Komisaruk BR, Whipple B. The suppression of pain by genital stimulation in females. Annu Rev Sex Res 1995; 6: 151–85.
- 12 Iggo A, Andres KH. Morphology of cutaneous receptors. Annu Rev Neurosci 1982; 5: 1–31.
- 13 Ting AY, Blacklock AD, Smith PG. Estrogen regulates vaginal sensory and autonomic nerve density in the rat. Biol Reprod 2004; 71: 1397–404.
- 14 Latini C, Frontini A, Morroni M, Marzioni D, Castellucci M, Smith PG. Remodeling of uterine innervation. Cell Tissue Res 2008; 334: 1–6.
- 15 Westrom LV, Willen R. Vestibular nerve fiber proliferation in vulvar vestibulitis syndrome. Obstet Gynecol 1998; 91: 572–6.
- 16 Bohm-Starke N, Hilliges M, Falconer C, Rylander E. Increased intraepithelial innervation in women with vulvar vestibulitis syndrome. Gynecol Obstet Invest 1998; 46: 256–60.
- 17 Halperin R, Zehavi S, Vaknin Z, Ben-Ami I, Pansky M, Schneider D. The major histopathologic characteristics in the vulvar vestibulitis syndrome. Gynecol Obstet Invest 2005; 59: 75–9.
- 18 Tympanidis P, Terenghi G, Dowd P. Increased innervation of the vulval vestibule in patients with vulvodynia. Br J Dermatol 2003; 148: 1021–7.
- 19 Aughton KL, Hamilton-Smith K, Gupta J, Morton JS, Wayman CP, Jackson VM. Pharmacological profiling of neuropeptides on rabbit vaginal wall and vaginal artery smooth muscle in vitro. Br J Pharmacol 2008; 155: 236–43.
- 20 Pessina MA, Hoyt RF, Jr., Goldstein I, Traish AM. Differential regulation of the expression of estrogen, progesterone, and androgen receptors by sex steroid hormones in the vagina: Immunohistochemical studies. J Sex Med 2006; 3: 804–14.
- 21 Johannesson U, Sahlin L, Masironi B, Rylander E, Bohm-Starke N. Steroid receptor expression in the vulvar vestibular mucosa—Effects of oral contraceptives and menstrual cycle. Contraception 2007; 76: 319–25.
- 22 Johannesson U, Sahlin L, Masironi B, et al. Steroid receptor expression and morphology in provoked vestibulodynia. Am J Obstet Gynecol 2008; 198: 311 e311–6.
- 23 Bohm-Starke N, Hilliges M, Falconer C, Rylander E. Neurochemical characterization of the vestibular nerves in women with vulvar vestibulitis syndrome. Gynecol Obstet Invest 1999; 48: 270–5.
- 24 Melzack R. Evaluation of the neuromatrix theory of pain. The Prithvi Raj Lecture: Presented at the third World Congress of World Institute of Pain, Barcelona, 2004. Pain Practice 2005; 5: 85–94.
- 25 Geppeti P. Neurogenic inflammation. Munchen: K.G. Saur Verlag; 1996
- 26 Elbadawi A. Interstitial cystitis: A critique of current concepts with a new proposal for pathologic diagnosis and pathogenesis. Urology 1997; 49: 14–40.
- 27 Steers WD, Tuttle JB. Neurogenic inflammation and nerve growth factor: Possible roles in interstitial cystitis. In: GR Sant, ed. Interstitial cystitis. Philadelphia: Lippincott-Raven Publishers; 1997: 67–75.
- 28 Wesselmann U. Neurogenic inflammation and chronic pelvic pain. World J Urol 2001; 19: 180–5.
- 29 Yoshimura N, De Groat WC. Increased excitability of afferent neurons innervating rat urinary bladder after chronic bladder inflammation. J Neurosci 1999; 19: 4644–53.
- 30 Fitzgerald MP, Koch D, Senka J. Visceral and cutaneous sensory testing in patients with painful bladder syndrome. Neurourol Urodyn 2005; 24: 627–32.
- 31 Wesselmann U, Lai J. Mechanisms of referred visceral pain: Uterine inflammation in the adult virgin rat results in neurogenic plasma extravasation in the skin. Pain 1997; 73: 309–17.
- 32 Giamberardino MA. Referred muscle pain/hyperalgesia and central sensitisation. J Rehabil Med 2003; 41(suppl): 85–8.
- 33 Bohm-Starke N, Hilliges M, Brodda-Jansen G, Rylander E, Torebjork E. Psychophysical evidence of nociceptor sensitization in vulvar vestibulitis syndrome. Pain 2001; 94: 177–83.
- 34 Bohm-Starke N, Johannesson U, Hilliges M, Rylander E, Torebjork E. Decreased mechanical pain threshold in the vestibular mucosa of women using oral contraceptives: A contributing factor in vulvar vestibulitis? J Reprod Med 2004; 49: 888–92.
- 35 Lowenstein L, Vardi Y, Deutsch M, et al. Vulvar vestibulitis severity–assessment by sensory and pain testing modalities. Pain 2004; 107: 47–53.
- 36 Pukall CF, Binik YM, Khalife S, Amsel R, Abbott FV. Vestibular tactile and pain thresholds in women with vulvar vestibulitis syndrome. Pain 2002; 96: 163–75.
- 37 Granot M, Friedman M, Yarnitsky D, Tamir A, Zimmer EZ. Primary and secondary vulvar vestibulitis syndrome: Systemic pain perception and psychophysical characteristics. Am J Obstet Gynecol 2004; 191: 138–42.
- 38 Giesecke J, Reed BD, Haefner HK, Giesecke T, Clauw DJ, Gracely RH. Quantitative sensory testing in vulvodynia patients and increased peripheral pressure pain sensitivity. Obstet Gynecol 2004; 104: 126–33.
- 39 Granot M, Friedman M, Yarnitsky D, Zimmer EZ. Enhancement of the perception of systemic pain in women with vulvar vestibulitis. BJOG 2002; 109: 863–6.
- 40 Pukall CF, Strigo IA, Binik YM, Amsel R, Khalife S, Bushnell MC. Neural correlates of painful genital touch in women with vulvar vestibulitis syndrome. Pain 2005; 115: 118–27.
- 41 Pukall CF, Baron M, Amsel R, Khalife S, Binik YM. Tender point examination in women with vulvar vestibulitis syndrome. Clin J Pain 2006; 22: 601–9.
- 42 Schweinhardt P, Kuchinad A, Pukall CF, Bushnell MC. Increased gray matter density in young women with chronic vulvar pain. Pain 2008; 140: 411–9.
- 43 Foster DC, Dworkin RH, Wood RW. Effects of intradermal foot and forearm capsaicin injections in normal and vulvodynia-afflicted women. Pain 2005; 117: 128–36.
- 44 Granot M, Zimmer EZ, Friedman M, Lowenstein L, Yarnitsky D. Association between quantitative sensory testing, treatment choice, and subsequent pain reduction in vulvar vestibulitis syndrome. J Pain 2004; 5: 226–32.
- 45 Bohm-Starke N, Brodda-Jansen G, Linder J, Danielsson I. The result of treatment on vestibular and general pain thresholds in women with provoked vestibulodynia. Clin J Pain 2007; 23: 598–604.
- 46 Sonni L, Cattaneo A, De Marco A, De Magnis A, Carli P, Marabini S. Idiopathic vulvodynia. Clinical evaluation of the pain threshold with acetic acid solutions. J Reprod Med 1995; 40: 337–41.
- 47 Pukall CF, Young RA, Roberts MJ, Sutton KS, Smith KB. The vulvalgesiometer as a device to measure genital pressure-pain threshold. Physiol Meas 2007; 28: 1543–50.
- 48 Johannesson U, De Boussard CN, Brodda Jansen G, Bohm-Starke N. Evidence of diffuse noxious inhibitory controls (DNIC) elicited by cold noxious stimulation in patients with provoked vestibulodynia. Pain 2007; 130: 31–9.
- 49 Foster DC. Vulvar disease. Obstet Gynecol 2002; 100: 145–63.
- 50 Haefner HK, Collins ME, Davis GD, et al. The vulvodynia guideline. J Low Genit Tract Dis 2005; 9: 40–51.
- 51 Bouchard C, Brisson J, Fortier M, Morin C, Blanchette C. Use of oral contraceptive pills and vulvar vestibulitis: A case-control study. Am J Epidemiol 2002; 156: 254–61.
- 52 Gerber S, Bongiovanni AM, Ledger WJ, Witkin SS. Defective regulation of the proinflammatory immune response in women with vulvar vestibulitis syndrome. Am J Obstet Gynecol 2002; 186: 696–700.
- 53 Stewart EG. Developments in vulvovaginal care. Curr Opin Obstet Gynecol 2002; 14: 483–8.
- 54 Sideri M, Jones RW, Wilkinson EJ, et al. Squamous vulvar intraepithelial neoplasia: 2004 modified terminology, ISSVD Vulvar Oncology Subcommittee. J Reprod Med 2005; 50: 807–10.
- 55 Willhite LA, O'Connell MB. Urogenital atrophy: Prevention and treatment. Pharmacotherapy 2001; 21: 464–80.
- 56 Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 1997; 89: 501–6.
- 57 Randall CL, Nichols DH. Surgical treatment of vaginal inversion. Obstet Gynecol 1971; 38: 327–32.
- 58 Higgs PJ, Chua HL, Smith AR. Long term review of laparoscopic sacrocolpopexy. BJOG 2005; 112: 1134–8.
- 59 Barber MD, Visco AG, Wyman JF, Fantl JA, Bump RC. Sexual function in women with urinary incontinence and pelvic organ prolapse. Obstet Gynecol 2002; 99: 281–9.
- 60 Kahn MA, Stanton SL. Posterior colporrhaphy: Its effects on bowel and sexual function. Br J Obstet Gynaecol 1997; 104: 82–6.
- 61 Benson JT, Lucente V, McClellan E. Vaginal versus abdominal reconstructive surgery for the treatment of pelvic support defects: A prospective randomized study with long-term outcome evaluation. Am J Obstet Gynecol 1996; 175: 1418–21; discussion 1421–22.
- 62 Maher CF, Qatawneh AM, Dwyer PL, Carey MP, Cornish A, Schluter PJ. Abdominal sacral colpopexy or vaginal sacrospinous colpopexy for vaginal vault prolapse: A prospective randomized study. Am J Obstet Gynecol 2004; 190: 20–6.
- 63 Baessler K, Maher CF. Mesh augmentation during pelvic-floor reconstructive surgery: Risks and benefits. Curr Opin Obstet Gynecol 2006; 18: 560–6.
- 64 El-Defrawi MH, Lotfy G, Dandash KF, Refaat AH, Eyada M. Female genital mutilation and its psychosexual impact. J Sex Marital Ther 2001; 27: 465–73.
- 65 Van Lankveld JJ, Grotjohann Y. Psychiatric comorbidity in heterosexual couples with sexual dysfunction assessed with the composite international diagnostic interview. Arch Sex Behav 2000; 29: 479–98.
- 66 Jantos M, White G. The vestibulitis syndrome. Medical and psychosexual assessment of a cohort of patients. J Reprod Med 1997; 42: 145–52.
- 67 Lundqvist EN, Bergdahl J. Vestibulodynia (former vulvar vestibulitis): Personality in affected women. J Psychosom Obstet Gynaecol 2005; 26: 251–6.
- 68 Granot M, Lavee Y. Psychological factors associated with perception of experimental pain in vulvar vestibulitis syndrome. J Sex Marital Ther 2005; 31: 285–302.
- 69 Brotto LA, Basson R, Gehring D. Psychological profiles among women with vulvar vestibulitis syndrome: A chart review. J Psychosom Obstet Gynaecol 2003; 24: 195–203.
- 70 Brauer M, Laan E, Ter Kuile MM. Sexual arousal in women with superficial dyspareunia. Arch Sex Behav 2006; 35: 191–200.
- 71 Payne KA, Binik YM, Pukall CF, Thaler L, Amsel R, Khalife S. Effects of sexual arousal on genital and non-genital sensation: A comparison of women with vulvar vestibulitis syndrome and healthy controls. Arch Sex Behav 2007; 36: 289–300.
- 72 Brauer M, Ter Kuile MM, Janssen SA, Laan E. The effect of pain-related fear on sexual arousal in women with superficial dyspareunia. Eur J Pain 2007; 11: 788–98.
- 73 Wouda JC, Hartman PM, Bakker RM, Bakker JO, Van De Wiel HBM. Vaginal plethysmography in women with dyspareunia. J Sex Res 1998; 35: 141–7.
- 74 Pukall CF, Meana M, Sutton KS. Psychological evaluation and measurement of dyspareunia. In: A Goldstein, CF Pukall, I Goldstein, eds. Female sexual pain disorders: Evaluation and measurement. Oxford, UK: Blackwell Publishing; 2009: 21–6.
- 75 Payne KA, Binik YM, Amsel R, Khalife S. When sex hurts, anxiety and fear orient attention towards pain. Eur J Pain 2005; 9: 427–36.
- 76 Brauer M, De Jong PJ, Huijding J, Laan E, Ter Kuile MM. Automatic and deliberate affective associations with sexual stimuli in women with superficial dyspareunia. Arch Sex Behav 2009; 38: 486–97.
- 77 Schover LR, Youngs DD, Cannata R. Psychosexual aspects of the evaluation and management of vulvar vestibulitis. Am J Obstet Gynecol 1992; 167: 630–6.
- 78 Reissing ED, Binik YM, Khalife S, Cohen D, Amsel R. Etiological correlates of vaginismus: Sexual and physical abuse, sexual knowledge, sexual self-schema, and relationship adjustment. J Sex Marital Ther 2003; 29: 47–59.
- 79 Van Lankveld JJ, Brewaeys AM, Ter Kuile MM, Weijenborg PT. Difficulties in the differential diagnosis of vaginismus, dyspareunia and mixed sexual pain disorder. J Psychosom Obstet Gynaecol 1995; 16: 201–9.
- 80 Reissing ED, Binik YM, Khalife S, Cohen D, Amsel R. Vaginal spasm, pain, and behavior: An empirical investigation of the diagnosis of vaginismus. Arch Sex Behav 2004; 33: 5–17.
- 81 De Jong PJ, Van Overveld M, Weijmar Schultz W, Peters ML, Buwalda FM. Disgust Sensitivity Contamination in Vaginismus and Dyspareunia. Arch Sex Behav 2007.
- 82
Reissing ED.
Vaginismus: Evaluation and Management. In: AT Goldstein,
CF Pukall,
I Goldstein, ed. Female sexual pain disorders: Evaluation and management. Oxford: Blackwell Publishing; 2009: 229–34.
10.1002/9781444308136.ch35 Google Scholar
- 83 Van Der Velde J, Everaerd W. Voluntary control over pelvic floor muscles in women with and without vaginistic reactions. Int Urogynecol J Pelvic Floor Dysfunct 1999; 10: 230–6.
- 84 Van Der Velde J, Everaerd W. The relationship between involuntary pelvic floor muscle activity, muscle awareness and experienced threat in women with and without vaginismus. Behav Res Ther 2001; 39: 395–408.
- 85 Van Der Velde J, Laan E, Everaerd W. Vaginismus, a component of a general defensive reaction. an investigation of pelvic floor muscle activity during exposure to emotion-inducing film excerpts in women with and without vaginismus. Int Urogynecol J Pelvic Floor Dysfunct 2001; 12: 328–31.
- 86 Ter Kuile MM, Van Lankveld JJ, De Groot E, Melles R, Neffs J, Zandbergen M. Cognitive-behavioral therapy for women with lifelong vaginismus: Process and prognostic factors. Behav Res Ther 2007; 45: 359–73.
- 87 Sutton KS, Pukall CF, Chamberlain S. Pain, psychosocial, sexual, and psychophysical characteristics of women with primary vs. secondary provoked vestibulodynia. J Sex Med 2009; 6: 205–14.
- 88 Burrows LJ, Klingman D, Pukall CF, Goldstein AT. Umbilical hypersensitivity in women with primary vestibulodynia. J Reprod Med 2008; 53: 413–6.
- 89 Bergeron S, Binik YM, Khalife S, et al. A randomized comparison of group cognitive—Behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis. Pain 2001; 91: 297–306.
- 90 Weijmar Schultz WC, Gianotten WL, Van Der Meijden WI, et al. Behavioral approach with or without surgical intervention to the vulvar vestibulitis syndrome: A prospective randomized and non-randomized study. J Psychosom Obstet Gynaecol 1996; 17: 143–8.
- 91 Meana M, Binik YM, Khalife S, Cohen DR. Biopsychosocial profile of women with dyspareunia. Obstet Gynecol 1997; 90: 583–9.
- 92
Johnson C.
Female genital cutting. In: A Goldstein,
CF Pukall,
I Goldstein, eds. Female sexual pain disorders: Evaluation and management. Oxford, UK: Blackwell Publishing; 2009: 235–43.
10.1002/9781444308136.ch36 Google Scholar
- 93 Schmidt S, Bauer A, Greif C, Merker A, Elsner P, Strauss B. Vulvar pain. Psychological profiles and treatment responses. J Reprod Med 2001; 46: 377–84.
- 94 Nunns D, Mandal D. Psychological and psychosexual aspects of vulvar vestibulitis. Genitourin Med 1997; 73: 541–4.
- 95 Sutton KS, Pukall CF, Chamberlain S. Pain ratings, sensory thresholds, and psychosocial functioning in women with provoked vestibulodynia. J Sex Marital Ther 2009; 35: 262–81.
- 96 Melzack R, Katz J. The McGill pain questionnaire: Appraisal and current status. In: DC Turk, R Melzack, eds. Handbook of pain assessment, 2nd edition. New York: Guilford Press; 2001: 35–52.
- 97 Rosen R, Brown C, Heiman J, et al. The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000; 26: 191–208.
- 98 Derogatis LR, Rosen R, Leiblum S, Burnett A, Heiman J. The Female Sexual Distress Scale (FSDS): Initial validation of a standardized scale for assessment of sexually related personal distress in women. J Sex Marital Ther 2002; 28: 317–30.
- 99 Beck AT, Steer RA, Brown GK. Beck depression Inventory manual, 2nd edition. San Antonio: Psychological Corporation; 1996.
- 100 Beck AT, Steer RA. Beck anxiety inventory. San Antonio: Psychological Corporation; 1990.
- 101 Spanier GB. Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads. J Marriage Family 1976; 38: 15–28.
- 102 Locke HJ, Wallace KM. Short marital adjustment and prediction tests: Their reliability and validity. Marriage Fam Living 1959; 21: 251–5.
- 103 Huber JD, Pukall CF, Boyer SC, Reissing ED, Chamberlain SM. Just relax”: Physicians' experiences with women who are difficult or impossible to examine gynecologically. J Sex Med 2009; 6: 791–9.
- 104 Carter J, Fowler J, Carson L, Carlson J, Twiggs LB. How accurate is the pelvic examination as compared to transvaginal sonography? A prospective, comparative study. J Reprod Med 1994; 39: 32–4.
- 105 Reissing ED, Brown C, Lord MJ, Binik YM, Khalife S. Pelvic floor muscle functioning in women with vulvar vestibulitis syndrome. J Psychosom Obstet Gynaecol 2005; 26: 107–13.
- 106 Glazer HI, Marinoff SC, Sleight IJ. Web-enabled Glazer surface electromyographic protocol for the remote, real-time assessment and rehabilitation of pelvic floor dysfunction in vulvar vestibulitis syndrome. A case report. J Reprod Med 2002; 47: 728–30.
- 107 Engman M, Lindehammar H, Wijma B. Surface electromyography diagnostics in women with partial vaginismus with or without vulvar vestibulitis and in asymptomatic women. J Psychosom Obstet Gynaecol 2004; 25: 281–94.
- 108 Danielsson I, Torstensson T, Brodda-Jansen G, Bohm-Starke N. EMG biofeedback versus topical lidocaine gel: A randomized study for the treatment of women with vulvar vestibulitis. Acta Obstet Gynecol Scand 2006; 85: 1360–7.
- 109 Friedrich EG, Jr. The vulvar vestibule. J Reprod Med 1983; 28: 773–7.
- 110 Baggish MS, Miklos JR. Vulvar pain syndrome: A review. Obstet Gynecol Surv 1995; 50: 618–27.
- 111 Pukall CF, Binik YM, Khalife S. A new instrument for pain assessment in vulvar vestibulitis syndrome. J Sex Marital Ther 2004; 30: 69–78.
- 112 Pukall CF, Payne KA, Binik YM, Khalife S. Pain measurement in vulvodynia. J Sex Marital Ther 2003; 29(Suppl 1): 111–20.
- 113 Pukall C, Kandyba K, Amsel R, Khalife S, Binik Y. Effectiveness of hypnosis for the treatment of vulvar vestibulitis syndrome: A preliminary investigation. J Sex Med 2007; 4: 417–25.
- 114 Goldfinger C, Pukall CF, Gentilcore-Saulnier E, McLean L, Chamberlain S. A prospective study of pelvic floor physical therapy: Pain and psychosexual outcomes in provoked vestibulodynia. J Sex Med 2009; 6: 1955–68.
- 115 Curnow JS, Barron L, Morrison G, Sergeant P. Vulval algesiometer. Med Biol Eng Comput 1996; 34: 266–9.
- 116 Tu FF, Fitzgerald CM, Kuiken T, Farrell T, Harden RN. Comparative measurement of pelvic floor pain sensitivity in chronic pelvic pain. Obstet Gynecol 2007; 110: 1244–8.
- 117 Haynes RB, Taylor DW, Sackett DL. Compliance in health care. Baltimore: Johns Hopkins University Press; 1979
- 118 Bornstein J, Livnat G, Stolar Z, Abramovici H. Pure versus complicated vulvar vestibulitis: A randomized trial of fluconazole treatment. Gynecol Obstet Invest 2000; 50: 194–7.
- 119 Nyirjesy P, Sobel JD, Weitz MV, Leaman DJ, Small MJ, Gelone SP. Cromolyn cream for recalcitrant idiopathic vulvar vestibulitis: Results of a placebo controlled study. Sex Transm Infect 2001; 77: 53–7.
- 120 Petersen CD, Giraldi A, Lundvall L, Kristensen E. Botulinum toxin type A-A novel treatment for provoked vestibulodynia? Results from a randomized, placebo controlled, double blinded study. J Sex Med 2009; 6: 2523–37.
- 121 Brown CS, Glazer HI, Vogt V, Menkes D, Bachmann G. Subjective and objective outcomes of botulinum toxin type A treatment in vestibulodynia: Pilot data. J Reprod Med 2006; 51: 635–41.
- 122 Dykstra DD, Presthus J. Botulinum toxin type A for the treatment of provoked vestibulodynia: An open-label, pilot study. J Reprod Med 2006; 51: 467–70.
- 123 Segal D, Tifheret H, Lazer S. Submucous infiltration of betamethasone and lidocaine in the treatment of vulvar vestibulitis. Eur J Obstet Gynecol Reprod Biol 2003; 107: 105–6.
- 124 Murina F, Tassan P, Roberti P, Bianco V. Treatment of vulvar vestibulitis with submucous infiltrations of methylprednisolone and lidocaine. An alternative approach. J Reprod Med 2001; 46: 713–6.
- 125 Steinberg AC, Oyama IA, Rejba AE, Kellogg-Spadt S, Whitmore KE. Capsaicin for the treatment of vulvar vestibulitis. Am J Obstet Gynecol 2005; 192: 1549–53.
- 126 Murina F, Radici G, Bianco V. Capsaicin and the treatment of vulvar vestibulitis syndrome: A valuable alternative? MedGenMed 2004; 6: 48.
- 127 Morrison GD, Adams SJ, Curnow JS. A preliminary study of topical ketoconazole in vulvar vestibulitis syndrome. J Dermatolog Treat 1996; 7: 219–21.
- 128 Pagano R. Vulvar vestibulitis syndrome: An often unrecognized cause of dyspareunia. Aust N Z J Obstet Gynaecol 1999; 39: 79–83.
- 129 Zolnoun DA, Hartmann KE, Steege JF. Overnight 5% lidocaine ointment for treatment of vulvar vestibulitis. Obstet Gynecol 2003; 102: 84–7.
- 130 McKay M. Dysesthetic (“essential”) vulvodynia. Treatment with amitriptyline. J Reprod Med 1993; 38: 9–13.
- 131 Munday PE. Response to treatment in dysaesthetic vulvodynia. J Obstet Gynaecol 2001; 21: 610–3.
- 132 Enck P, Benedetti F, Schedlowski M. New insights into the placebo and nocebo responses. Neuron 2008; 59: 195–206.
- 133 Bergeron S, Khalife S, Glazer HI, Binik YM. Surgical and behavioral treatments for vestibulodynia: Two-and-one-half year follow-up and predictors of outcome. Obstet Gynecol 2008; 111: 159–66.
- 134 Goldstein AT, Klingman D, Christopher K, Johnson C, Marinoff SC. Surgical treatment of vulvar vestibulitis syndrome: Outcome assessment derived from a postoperative questionnaire. J Sex Med 2006; 3: 923–31.
- 135 Traas MA, Bekkers RL, Dony JM, et al. Surgical treatment for the vulvar vestibulitis syndrome. Obstet Gynecol 2006; 107: 256–62.
- 136 Goetsch MF. Simplified surgical revision of the vulvar vestibule for vulvar vestibulitis. Am J Obstet Gynecol 1996; 174: 1701–5. discussion 1705–7.
- 137 Haefner HK. Critique of new gynecologic surgical procedures: Surgery for vulvar vestibulitis. Clin Obstet Gynecol 2000; 43: 689–700.
- 138 Block AR. Presurgical psychological screening in chronic pain syndromes: Psychosocial risk factors for poor surgical results. In: RJ Gatchel, DC Turk, eds. Psychosocial factors in pain: Critical perspectives. New York: The Guilford Press; 1999: 390–400.
- 139 Bohm-Starke N, Rylander E. Surgery for localized, provoked vestibulodynia: A long-term follow-up study. J Reprod Med 2008; 53: 83–9.
- 140 Romito S, Bottanelli M, Pellegrini M, Vicentini S, Rizzuto N, Bertolasi L. Botulinum toxin for the treatment of genital pain syndromes. Gynecol Obstet Invest 2004; 58: 164–7.
- 141
Foster DC,
Butts C,
Shah KV,
Woodruff JD.
Long term outcome of perineoplasty for vulvar vestibulitis.
J Women's Health
1995; 4: 669–75.
10.1089/jwh.1995.4.669 Google Scholar
- 142 Weijmar Schultz W, Basson R, Binik Y, Eschenbach D, Wesselmann U, Van Lankveld J. Women's sexual pain and its management. J Sex Med 2005; 2: 301–16.
- 143 Praharaj SK, Verma P, Arora M. Topical lignocaine for vaginismus: A case report. Int J Impot Res 2006; 18: 568–9.
- 144 Seo JT, Choe JH, Lee WS, Kim KH. Efficacy of functional electrical stimulation-biofeedback with sexual cognitive-behavioral therapy as treatment of vaginismus. Urology 2005; 66: 77–81.
- 145 Brin MF, Vapnek JM. Treatment of vaginismus with botulinum toxin injections. Lancet 1997; 349: 252–3.
- 146 Plaut SM, RachBeisel J. The use of anxiolytic medication in the treatment of vaginismus and severe aversion to penetration: A case report. J Sex Educ Ther 1997; 22: 43–5.
- 147 Addar MH. The unconsummated marriage: Causes and management. Clin Exp Obstet Gynecol 2004; 31: 279–81.
- 148 McGuire H, Hawton K. Interventions for vaginismus. Cochrane Database Syst Rev 2003: CD001760.
- 149 Ter Kuile MM, Bulte I, Weijenborg PT, Beekman A, Melles R, Onghena P. Therapist-aided exposure for women with lifelong vaginismus: A replicated single-case design. J Consult Clin Psychol 2009; 77: 149–59.
- 150 Drenth JJ, Andriessen S, Heringa MP, Mourits MJ, Van De Wiel HB, Weijmar Schultz WC. Connections between primary vaginismus and procreation: Some observations from clinical practice. J Psychosom Obstet Gynaecol 1996; 17: 195–201.
