Women with genital pain have low pain threshold

The cause of vulvodynia - painful discomfort in the vulva - is unknown, but researchers have now found that women with the condition are abnormally sensitive to all bodily pain stimuli.

This suggests that vulvodynia might respond to treatments aimed at general pain control rather than specifically to the vulvar area.

Dr. Jutta Giesecke and colleagues from University of Michigan, Ann Arbor, studied 17 women with vulvodynia.

As expected, these women had significantly lower pain thresholds at all sites tested in the vulvar region than did a comparison group, the authors report in the medical journal Obstetrics & Gynecology.

Moreover, the team found that women with vulvodynia were more sensitive to pain from pressure applied at peripheral sites - the deltoid, shin, and thumb - than were women without vulvar discomfort.

Pain thresholds did not differ significantly between analogous sites on the right and left body side, the report indicates.

Pressure pain sensitivity at vulvar and peripheral sites did not differ between white and African-American “control” subjects, the researchers note, and pain thresholds did not differ between women with localized vulvar pain and women with generalized vulvar discomfort.

The finding that women suffering from vulvodynia have diffuse increased peripheral pressure pain sensitivity “implies that some individuals with this condition might benefit from treatments aimed at more ‘central’ causes of pain,” Giesecke and colleagues write.

That is, certain classes of antidepressants, aerobic exercise, or cognitive behavioral therapy might be beneficial “in addition to (or instead of) therapies directed at the vulvar region.”

SOURCE: Obstetrics & Gynecology, July 2004.

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Revision date: June 18, 2011
Last revised: by Janet A. Staessen, MD, PhD