Sexual wellbeing in vulvodynia: A narrative review

Vulvodynia, defined as idiopathic chronic vulvar pain, is a prevalent and distressing condition that entails significant impacts on many aspects of psychosocial wellbeing. Given the location of the pain in vulvodynia and the unique sexual challenges faced by individuals with this condition, the purpose of the present paper was to narratively review the literature on sexual wellbeing in vulvodynia. In the face of evolving definitions of sexual wellbeing, we examined the following aspects: sexual function, pain during sexual activity, sexual satisfaction, sexual pleasure, and genital self-image. Secondary aims were to examine the frequency with which these aspects are studied, to report on premenopausal or postmenopausal status of the samples, and to describe the subtypes of vulvodynia featured in the literature. A search for articles in Medline, PsycINFO, and Web of Science examining these aspects in the last 10 years yielded 54 studies for inclusion and extraction. Results indicated that sexual function, pain during sexual activity, and sexual satisfaction are the most common aspects of sexual wellbeing studied in the vulvodynia literature. Sexual pleasure and genital self-image, however, are not frequently assessed in vulvodynia studies. In addition, the vulvodynia literature focused predominantly on premenopausal samples with provoked pain. Numerous psychosocial factors were found to be associated with sexual wellbeing outcomes, including intrapersonal and interpersonal aspects. These factors should be considered as intervention targets in the management of vulvodynia, given the widespread effects of this condition.