Vulvodynia is a distressing medical condition that is defined as vulvar pain that lasts for at least three months without an identifiable cause. People with vulvodynia often describe their symptoms as burning, itching, cutting, stinging, and lacerating. They may experience difficulty or pain with sexual activity, tampon insertion, gynecological examinations, and urination.

An estimated 8% to 16% of people with a vulva experience vulvodynia, and this number is likely to be even higher because vulvodynia is often misdiagnosed or even dismissed as not a real health issue.

Given the striking number of barriers facing individuals with vulvodynia, the authors of a new study decided to conduct a rigorous literature search on all publications related to vulvodynia to determine the most common psychosocial barriers for patients.

The initial search yielded 671 articles related to the topic. However, once the duplicates and articles that did not address psychosocial barriers of vulvodynia were removed, a total of 73 articles remained. The researchers then divided the barriers into one of the following three categories: psychosocial, interpersonal, and structural and environmental barriers.

Psychosocial Barriers

Psychosocial barriers impact a person’s mental health and personal and social well-being. The psychosocial barriers found to be associated with vulvodynia were the anticipation of pain; anxiety, depression, and catastrophizing; a lack of self-efficacy; fear; low desire and arousal; negative body image; stigma; distress; PTSD, child maltreatment, and abuse; mistrust; invalidation and isolation; and low levels of self-compassion.

Interpersonal Barriers

As the name suggests, interpersonal barriers have to do with the barriers and challenges that exist between two or more people. Several interpersonal barriers were found to be associated with vulvodynia including negative partner support; low relationship satisfaction; lack of physical affection; poor emotional regulation; avoidance; and lack of “approach” goals (i.e., goals focused on obtaining a positive outcome).

Structural and Environmental Barriers

Lastly, structural and environmental barriers are outside factors that can contribute to further increasing distress and anxiety related to a situation. People with vulvodynia face many structural and environmental barriers in addition to the other challenges they face. Some of these barriers include delayed diagnosis; an extensive time commitment; low health literacy; the cost of seeking medical care; location and transportation barriers; diversity and race issues (including racism in health care centers); and even disbelief among some health care providers.

All of these barriers can stack up to make vulvodynia feel like an insurmountable problem, but as people continue to become more educated and aware of this condition, some of these things may begin to change. Ultimately, more education on vulvodynia for both patients and providers may help lead to earlier diagnoses, fewer doctors’ visits, and quicker access to treatment options for people who are suffering from this condition.

References:

• Niedenfuehr, J., Edwards, M., & King, L.M. (2023). A scoping review: the psychosocial barriers that exist for people with vulvodynia. The Journal of Sexual Medicine, 20(6), https://doi.org/10.1093/jsxmed/qdad035