Refining Diagnostic Criteria of a Pain Disorder: Vulvar Vestibulitis Syndrome

In order to participate an individual had to be:

  1. Between the ages 21-45
  2. Been diagnosed by a doctor with VVS and/or experience pain in the vaginal region upon contact (e.g. intercourse, tampon insertion, pelvic exam). Or have no prior history of pain with intercourse or pain on contact
  3. Be premenopausal and NOT pregnant

 

Study Overview

  • The study involved undergoing sensory testing and modified gynecological exams
  • Required 2 visits to UNC Hospitals over the course of 2 weeks

 

Purpose

Vulvar vestibulitis syndrome (VVS), the most common type of chronic vulvovaginal pain, impairs the psychological, physical, and reproductive health of nearly 1 in 10 women at some point in their lifetime. The cause of VVS is not clearly understood and current treatments are only slightly effective.  The purpose of this research study is to learn how VVS develops so that in the future, better treatments can be found.

The development of pain disorders, like VVS, is influenced by both genetic and environmental factors (e.g. stress, diet, medications, etc.). In order to understand how these influences interact, comprehensive research looking at genes in different groups of people is needed. Therefore, genetic material called DNA obtained from the white blood cells in your blood will be used to search for genes related to VVS. These results will be used to identify genetic differences between women who have VVS, do not have VVS, and those who suffer from varying degrees of symptoms.

A second goal of this study is to see whether women who have VVS and women who are healthy controls have symptoms of Irritable Bowel Syndrome (IBS) and whether there are genetic differences in their blood.  Some of the symptoms of IBS are diarrhea, abdominal pain and constipation.  IBS and VVS are both called idiopathic pain disorders.  This means that doctors do not know what causes them and they are thought to have similar nerve pathways that lead to pain and other symptoms.  Understanding how these conditions are the same may be important so better treatments and tests to diagnose the conditions can be developed.

In the study, we plan to:

  1. Evaluate a modified algometer (pressure sensing instrument) designed to measure how sensitive your vulvar skin is to pain caused by pressure.  This tool is experimental and this is the first time we are using this tool for the purposes of research on human subjects.
  2. Evaluate a modified algometer (pressure sensing instrument) designed to measure how sensitive your pelvic floor muscles are to pain caused by pressure.  This tool is experimental and this is the first time we are using this tool for the purposes of research on human subjects.
  3. Compare women with VVS to women without VVS regarding sensitivity to pain in the vulvar area and in the pelvic muscles.
  4. Investigate the incidence of IBS among women with VVS compared to women without VVS.
  5. Compare genetic markers between healthy controls and women with varying degrees of VVS.

 

Results

We are currently conducting data analysis for this study.