Vulvodynia—It Is Time to Accept a New Understanding from a Neurobiological Perspective

Rafael Torres-Cueco and Francisco Nohales-Alfonso
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Rafael Torres-Cueco: Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
Francisco Nohales-Alfonso: Gynecology Section, Clinical Area of Women’s Diseases, La Fe University Hospital, 46010 Valencia, Spain

IJERPH, 2021, vol. 18, issue 12, 1-17

Abstract: Vulvodynia is one the most common causes of pain during sexual intercourse in premenopausal women. The burden of vulvodynia in a woman’s life can be devastating due to its consequences in the couple’s sexuality and intimacy, in activities of daily living, and psychological well-being. In recent decades, there has been considerable progress in the understanding of vulvar pain. The most significant change has been the differentiation of vulvar pain secondary to pathology or disease from vulvodynia. However, although it is currently proposed that vulvodynia should be considered as a primary chronic pain condition and, therefore, without an obvious identifiable cause, it is still believed that different inflammatory, genetic, hormonal, muscular factors, etc. may be involved in its development. Advances in pain neuroscience and the central sensitization paradigm have led to a new approach to vulvodynia from a neurobiological perspective. It is proposed that vulvodynia should be understood as complex pain without relevant nociception. Different clinical identifiers of vulvodynia are presented from a neurobiological and psychosocial perspective. In this case, strategies to modulate altered central pain processing is necessary, changing the patient’s erroneous cognitions about their pain, and also reducing fear avoidance-behaviors and the disability of the patient.

Keywords: vulvodynia; complex pain; central sensitization pain; cognitive-behavioral therapy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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