• Lori A Brotto, Leslie A Sadownik, Sydney Thomson, Marcy Dayan, Kelly B Smith, Brooke N Seal, Melissa Moses, and Areiyu Zhang.
• *Department of Gynaecology §Faculty of Medicine, University of British Columbia †Dayan Physiotherapy and Pelvic Floor Clinic, Vancouver ‡Department of Psychology, University of the Fraser Valley, Abbotsford, BC, Canada.
• Clin J Pain. 2014 May 1;30(5):428-35.

ObjectivesProvoked vestibulodynia (PVD) is a distressing genital pain condition affecting approximately 12% of premenopausal women. It has been speculated that primary (ie, lifelong) and secondary (ie, acquired) PVD may represent 2 distinct conditions with different etiologies. There is also evidence that primary and secondary PVD subtypes may respond differently to conventional treatments. The goal of this study was to compare the demographic, clinical, and psychosexual characteristics of a large sample of premenopausal women with primary and secondary PVD.MethodsA total of 132 premenopausal women (n=42 primary; n=90 secondary) with PVD who sought treatment in a Multidisciplinary Vulvodynia Program completed demographic questions and a battery of validated self-report measures before treatment.ResultsWomen with primary PVD had a longer duration of PVD as well as more time before diagnosis. Women with secondary PVD reported significantly more clitoral hood pain, higher overall vestibular pain levels, more overall sexual dysfunction and sex-related distress, and proportionately more intercourse occasions that were painful. Women with primary pain stated they had significantly more dysmenorrhea and were more likely to report that their partners were unaware of their PVD symptoms. There were no significant subtype differences on any psychological measure but a trend towards higher magnification of symptoms in women with secondary PVD.DiscussionOverall the findings suggest some important differences in the characteristics of women with primary versus secondary PVD which may have management-related implications.

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