Abstract

Objective: Investigate pain sensitivity in women with vestibulodynia using two experimental pain assessments outside the vulvar region: intramuscular infusion of an acidic phosphate buffer and pressure pain thresholds (PPTs) of the lower limb.

Methods: Three women with a history of vestibulodynia (all 24 years old) participated after providing written informed consent. PPTs of the lower limb were assessed using a hand-held Somedic digital algometer (30 kilopascal (kPa)/sec) at baseline (pre-infusion) and during the intramuscular infusion. The acidic phosphate buffer (pH 5.2) was infused into the anterior tibialis muscle at a rate of 40 ml/hr for 15 min (10 ml total). Peak local (infusion site) and referred (ankle) pain ratings were assessed verbally, as well as vulvar pain at the time of the infusion (0 – 10 Borg Scale).

Results: Peak local pain was higher in two of the three subjects (2.5, 4.0, 9.5) than the average pain ratings in 34 healthy age-matched (21 – 27 years old) women from our laboratory, mean 3.0/10 (standard deviation (SD) 2.2; range 0.5 to 10). Peak referred pain was also higher in the same two subjects (0, 4.25, and 7.5) than the average of the controls (mean 1.5; SD 1.8; range 0 – 9.0). Similarly, vulvar pain patients all exhibited greater mechanical pain sensitivity (lower PPT values) than the average of the healthy controls (mean [SD] 246.3 [101.7] kPa in patients vs. 431.3 [109.33] in controls).

Conclusion: Preliminary data suggests women with vestibulodynia may exhibit greater generalized pain sensitivity to noxious stimuli than the general population of women.

Keywords: Pain sensitivity, vestibulodynia, vulvodynia, pressure pain thresholds, hyperalgesia, central sensitization

How to Cite:

Frey Law, L. & Whitis, A. M. & Stockdale, C. K., (2017) “Experimental pain sensitivity in women with vestibulodynia: a pilot study”, Proceedings in Obstetrics and Gynecology 7(1), 1-8. doi: https://doi.org/10.17077/2154-4751.1348

Rights: Copyright © 2017 the authors