• Michal Granot, Michael Friedman, David Yarnitsky, and Etan Z Zimmer.
• Faculty of Health and Welfare Studies, University of Haifa, Department of Neurology, Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel.
• BJOG. 2002 Aug 1;109(8):863-6.

ObjectiveThe aim of this study was to determine whether the characteristics of systemic pain perception and anxiety differ between women with vulvar vestibulitis and healthy women.DesignCase control study.SettingTertiary care hospital.PopulationForty-four women with vulvar vestibulitis and 41 healthy women participated in the study.MethodsFirst, the women's state and trait anxiety was evaluated. Thereafer, heat pain stimuli were applied to the women's forearm and the pain and unpleasantness thresholds, as well as magnitude estimation of perceived intensity and unpleasantness of suprathreshold stimuli, were assessed. Finally, blood pressure was measured before, during and after a heat stimulus of 46 degrees C.Main Outcome MeasuresPain threshold and suprathreshold, and anxiety levels of women with vulvar vestibulitis.ResultsWomen with vulvar vestibulitis had a higher anxiety state (40.0 [12.8] vs 34.1 [10.8], P = 0.044), a higher anxiety trait (42.1 [10.2] vs 35.6 [7.5], P = 0.005), a lower pain threshold (42.2 degrees C [2.5] vs 43.6 degrees C [1.9], P = 0.006), a lower unpleasantness threshold (40.2 degrees C [2.9] vs 41.7 degrees C [2.3], P = 0.023), a higher magnitude estimation of suprathreshold pain at 47 degrees C (88.3 [14.9] vs 70.8 [14.9], P = 0.0001) and at 48 degrees C (96.1 [7.3] vs 84.6 [14.8], P < 0.0001), a higher scoring of tonic pain perception (65.2 [17.3] vs 53.0 [18.6], P = 0.006) and a higher increase in systolic blood pressure during tonic pain stimuli (4.6 [9.6] vs -2.1 [8.7] mmHg, P = 0.005).ConclusionWomen with vulvar vestibulitis have an enhanced systemic pain perception and are more anxious.

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