Enhancement of the perception of systemic pain in women with vulvar vestibulitis

Objective The 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. Design Case control study. Setting Tertiary care hospital. Population Forty-four women with vulvar vestibulitis and 41 healthy women participated in the study. Methods First, the women's state and trait anxiety was evaluated. Thereafter, 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 46degreesC. Main outcome measures Pain threshold and suprathreshold, and anxiety levels of women with vulvar vestibulitis. Results Women 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 (42.2degreesC [2.5] vs 43.6degreesC [1.9], P = 0.006). a lower unpleasantness threshold (40.2degreesC [2.9] vs 41.7degreesC [2.3], P = 0.023), a higher magnitude estimation of suprathreshold pain at 47degreesC (88.3 [14.9] vs 70.8 [14.9], P = 0.0001) and at 48degreesC (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). Conclusion Women with vulvar vestibulitis have an enhanced systemic pain perception and are more anxious.