Date of Graduation

Summer 8-12-2017

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

Abstract

Abstract

Background: Vulvodynia is a multifactorial pain disorder characterized by vulvar pain, irritation, and dyspareunia resulting in physical, sexual, and psychological distress. The symptoms that women experience have a significant impact not only on their sexual functioning but also on their psychological well-being and overall quality of life. Currently there is no consensus among health care providers on the approach or treatment strategies for vulvodynia. This systematic review examines whether the use of a multidisciplinary approach can be a more effective treatment of dyspareunia in women with provoked vestibulodynia (PVD).

Methods: An exhaustive search of available medical literature was performed using MEDLINE-PubMed, Web of Science, Google Scholar, and CINAHL. Keywords searched included: vulvodynia, vestibulodynia, dyspareunia, and multidisciplinary. Articles were assessed using GRADE criteria.

Results: After completing a search 3 articles were selected that met all inclusion criteria. All 3 articles were observational studies, 2 of which were retrospective and 1 prospective. All studies showed a reduction in dyspareunia and coital pain in women with vulvodynia who had completed a multidisciplinary treatment program. These studies demonstrated a range of reduction of vulvodynia in 53.8%-81% of affected women. Length of treatment and length of follow-up varied among all studies. Future RCTs are needed to establish the efficacy of multidisciplinary vulvodynia programs (MVPs) on women with vulvodynia in comparison to one-dimensional treatments.

Conclusion: The use of a multidisciplinary treatment approach can lead to substantial improvements in vulvar pain and dyspareunia in women with vulvodynia or PVD. Evidence showed strong support for the immediate and long-term benefits of MVP. Future research using randomized control trials, long-term follow-up, and standardized outcome measurements should be conducted to further examine the benefits of MVP.

Keywords: Vulvodynia, vestibulodynia, dyspareunia, and multidisciplinary

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