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Clinical Journal of Pain:
doi: 10.1097/AJP.0000000000000087
Original Article: PDF Only

Natural History of Comorbid Orofacial Pain Among Women with Vestibulodynia.

Bair, Eric MS, PhD; Simmons, Elizabeth BS; Hartung, Jessica BS, MS; Desia, Kinnari MD, MPH; Maixner, William DDS, PhD; Zolnoun, Denniz MD, MPH

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Objectives: We evaluated the stability of the comorbidity between vulvodynia and orofacial pain (OFP) and its associated clinical characteristics over a two-year follow up period.

Methods: In an earlier study of vestibulodynia patients, we administered questionnaires assessing demographic data, self-reported pain, anxiety, somatic awareness, and presence of signs and symptoms suggestive of clinical and subclinical orofacial pain (OFP). The present study readministered the same surveys to a subset of the original cohort after a two-year follow up period.

Results: Of the 138 women in the previous study, 71 (51%) agreed to participate in the present study. We confirmed our earlier findings that (1) orofacial pain is a highly prevalent (66%) condition among women with vestibulodynia, and (2) compared to women with no OFP symptoms, those with OFP symptoms experience higher levels of anxiety (P=0.005), and somatic awareness (P<0.001). While OFP symptoms showed improvement in many of the vestibulodynia patients (33%) with OFP symptoms at baseline, 13% had either developed new symptoms or transitioned from subclinical to clinical OFP classification. Intercourse-related pain decreased in 69% of patients and increased in 24% of patients. Consistent with our earlier report, we did not observe significant differences with respect to demographics or severity of pain during intercourse among the subgroups.

Discussion: Orofacial pain is a common comorbidity among women with vestibulodynia, although the presence of OFP can vary over time. The comborbidity between vestibulodynia and OFP suggests that common underlying mechanisms may mediate both conditions.

(C) 2014 by Lippincott Williams & Wilkins

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