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Clinical Journal of Pain:
doi: 10.1097/AJP.0000000000000087
Original Articles

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 2-year follow-up period.

Materials and 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 OFP. The present study readministered the same surveys to a subset of the original cohort after a 2-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) OFP is a highly prevalent (66%) condition among women with vestibulodynia, and (2) compared with women with no OFP symptoms, those with OFP symptoms experience higher levels of anxiety (P=0.005) and somatic awareness (P<0.001). Although 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: OFP is a common comorbidity among women with vestibulodynia, although the presence of OFP can vary over time. The comorbidity between vestibulodynia and OFP suggests that common underlying mechanisms may mediate both conditions.

© 2015 by Lippincott Williams & Wilkins

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