Understanding vulvodynia: intersecting psychology, pain and identity

Introduction: Vulvodynia, a chronic vulvar pain disorder affecting approximately 16% of women, is a complex and multifactorial condition with an unknown etiology, lasting at least three months. It impacts somatic, psychological, relational, and sexual socialization dimensions. Although recent research on vulvodynia has been growing, few studies have investigated its psychophysiological etiology and somatic aspects. The present study adopts a biopsychosocial approach to explore the etiological, predisposing, and maintaining factors of vulvodynia by examining the complex experiences of women living with the condition. Methods: Twenty-five participants diagnosed with vulvodynia, aged between 18 and 55 years, were administered the Clinical Diagnostic Interview (CDI), supplemented with additional questions to investigate the development of the condition and personal experience. The interviews are part of a larger study that also includes personality profile assessments through the SWAP-200, and an online questionnaire measuring psychological distress (K-10), mentalized affectivity (B-MAS), body image (BUT), traumatic experiences (CTQ-SF), identity related to the body (IDEA), personality traits (PID-5- BF), sexual satisfaction (SSS-W), and thoughts associated with sexuality (SMQ-AT). Results: Using Reflexive Thematic Analysis, several common themes were identified, including the relationship with the body, experiences with sexuality (satisfaction and functioning), the domain of relationships, experiences of violence, and gender representations. The qualitative data were analyzed alongside preliminary quantitative data from the assessment instruments, providing insights into the psychological and somatic dynamics of vulvodynia. Discussion: These preliminary findings aim to enhance the understanding of vulvodynia by highlighting its complex psychophysiological nature. By integrating psychological and somatic factors, this study advocates for a more holistic approach to vulvodynia, which has significant implications for both research and clinical treatment, providing guidance for more personalized therapeutic interventions.