The Link Between Painful Sex and Chronic Pain Syndromes

Is your vagina depressed? Charlotte from the HBO show Sex and the City thought so after her gynecologist had prescribed her an antidepressant for a diagnosis of vulvodynia – a debilitating pain syndrome that afflicts the genital region in nearly 6 million women. Now, new research from the University of Michigan in Ann Arbor links vulvodynia with other complex pain syndromes including musculoskeletal pain (fibromyalgia), irritable bowel syndrome, and bladder pain (interstitial cystitis). The researchers, led by Dr. Barbara Reed, found that women with vulvodynia were up to three times more likely to develop one or more of these other debilitating conditions.

The sexy HBO sitcom comically put vulvodynia in the national spotlight back in 2001. More recently, a discussion on The Dr. Oz Show with Dr. Jennifer Ashton informed the nation of its debilitating nature. Vulvodynia is a poorly understood pain syndrome that affects the vulva, which surrounds the opening of the vagina. The pain can be constant or only occur during intercourse. Patients have likened the pain to an “acid-burning sensation” or “sharp knife-like stabbing” in their genitals. At the doctor’s office, it can be diagnosed with a simple “Q-tip test,” which assesses the severity of the genital pain.

No one knows the exact cause of vulvodynia. It is only diagnosed when other infectious, dermatologic or cancerous causes of pain have been ruled out. Many have linked the pain to prior physical or psychological trauma. Research also suggests a possible genetic predisposition. Despite our unfamiliarity with the condition’s cause, 16% of women will experience vulvodynia at some point during their lives.

The connection between vulvodynia and other similarly complex pain disorders may be explained by the diseases’ common mechanisms. All four conditions are linked to disturbances in the nervous system. Disturbances in pain fibers (also known as nocireceptors) can lead to overstimulation and more frequent transmission of pain to the brain. Fibromyalgia, the most complex and misunderstood of the pain syndromes, involves body-wide aches and pains that afflict the joints, muscles, tendons and soft tissues – all likely due to faulty nocireceptor transmission.

The researchers also found that women with already existing fibromyalgia, irritable bowel syndrome, or interstitial cystitis had a higher risk of developing vulvodynia in the future. The connection between vulvodynia and the other chronic pain syndromes spanned women of all ages and ethnicities. The researchers also couldn’t connect the severity of vaginal pain with the other chronic pain conditions. Even those with mild cases of vulvar pain had the same risks of developing other disorders as those with more severe vulvodynia.

According to the Institute of Medicine, 116 million persons in the United States suffer from chronic pain conditions that are still poorly understood and severely underdiagnosed. Unfortunately, many patients are misdiagnosed or told that the pain is only in their head. The sheer number of afflicted people substantiates the need for further research.

If you’re concerned that you may be experiencing symptoms of vulvodynia, fortunately, many treatment options exist, which include relaxation techniques, lifestyle modifications and medications. Talk with your doctor about choosing the best treatment for you.