Skip to main content
SpringerLink
Log in

Treatment of Genito-Pelvic Pain/Penetration Disorder

  • Chapter
  • First Online:
The Textbook of Clinical Sexual Medicine

Abstract

The objective of this chapter is to review strategies for management of genito-pelvic pain/penetration disorder (GPPPD). GPPPD refers to pain or fear of pain with sexual genital contact or vaginal penetration. This broad diagnosis demands a comprehensive evaluation and a multiplatform management strategy. GPPPD is commonly associated with specific diagnoses including localized vulvodynia, vulvar dermatoses, hormonally related atrophy, neuropathy, vaginismus, pelvic floor hypertonus and myalgia, and chronic pelvic pain conditions such as endometriosis and bladder pain syndromes. Typically, multiple diagnoses underlie dyspareunia. Treatment is dependent on identification of all components of pain. Psychological, interpersonal, and cultural dynamics must be addressed. Multidisciplinary management generally combines medication, physical therapy, psychological therapy, and when indicated, surgery. This chapter presents evidence-based treatment modalities for each of the conditions commonly associated with GPPPD.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. American Psychiatric Association. Diagnostic and statistical manuel of mental disorders (5th ed., Text Rev). Washington: American Psychiatric Association; 2013.

    Book  Google Scholar 

  2. Bergeron S, Corsini-Munt S, Aerts L, Rancourt K, Rosen N. Female sexual pain disorders: a review of the literature on etiology and treatment. Curr Sex Health Rep. 2015;7(3):159–69.

    Article  Google Scholar 

  3. Bornstein J, Goldstein AT, Stockdale CK, Bergeron S, Pukall C, Zolnoun D, Coady D. Consensus vulvar pain terminology committee of the International Society for the Study of Vulvovaginal Disease (ISSVD), the International Society for the Study of Womenʼs Sexual Health (ISSWSH), and the International Pelvic Pain Society (IPPS). Obstet Gynecol. 2016;127(4):745–51. doi:10.1097/AOG.0000000000001359.

    Article  PubMed  Google Scholar 

  4. Harlow BL, Kunitz CG, Nguyen RH, Rydell SA, Turner RM, MacLehose RF. Prevalence of symptoms consistent with a diagnosis of vulvodynia: population-based estimates from 2 geographic regions. Am J Obstet Gynecol. 2014;210(1):40.

    Article  PubMed  Google Scholar 

  5. Pukall CF, Goldstein AT, Bergeron S, Foster D, Stein A, Kellogg-Spadt S, Bachmann G. Vulvodynia: definition, prevalence, impact, and pathophysiological factors. J Sex Med. 2016;13(3):291–304. doi:10.1016/j.jsxm.2015.12.021.

    Article  PubMed  Google Scholar 

  6. American College of Obstetricians and Gynecologists Committee Opinion. Persistent vulvar pain. Number 673, September 2016;128:78–84.

    Google Scholar 

  7. Lamvu G, Nguyen RH, Burrows LJ, Rapkin A, Witzeman K, Marvel RP, Hutchins D, Witkin SS, Veasley C, Fillingim R, Zolnoun D. The evidence-based vulvodynia assessment project. A national registry for the study of vulvodynia. The evidence-based vulvodynia assessment project. A national registry for the study of vulvodynia. J Reprod Med. 2015;60(5–6):223–35.

    PubMed  Google Scholar 

  8. Sarton J. Assessment of the pelvic floor muscles in women with sexual pain. J Sex Med. 2010;7:3526–9.

    Article  PubMed  Google Scholar 

  9. Al-Abbadey M, Liossi C, Curran N, Schoth DE, Graham CA. Treatment of female sexual pain disorders: a systematic review. J Sex Marital Ther. 2016;42(2):99–142. doi:10.1080/0092623X.2015.1053023.. Epub 2015 Jun 2.

    Article  PubMed  Google Scholar 

  10. Goldstein AT, Pukall CF, Brown C, Bergeron S, Stein A, Kellogg-Spadt S. Vulvodynia: assessment and treatment. J Sex Med. 2016;13(4):572–90. doi:10.1016/j.jsxm.2016.01.020.. Epub 2016 Mar 25.

    Article  PubMed  Google Scholar 

  11. Landry T, Bergeron S, Dupuis MJ, Desrochers G. The treatment of provoked vestibulodynia: a critical review. Clin J Pain. 2008;24(2):155–71. doi:10.1097/AJP.0b013e31815aac4d.

    Article  PubMed  Google Scholar 

  12. Sadownik LA. Etiology, diagnosis, and clinical management of vulvodynia. Int J Womens Health. 2014;6:437–49.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Yong PJ, Sadownik L, Brotto LA. Concurrent deep-superficial dyspareunia: prevalence, associations, and outcomes in a multidisciplinary vulvodynia program. J Sex Med. 2015;12(1):219–27.

    Article  PubMed  Google Scholar 

  14. De Andres J, Sanchis-Lopez N, Asensio-Samper JM, Fabregat-Cid G, Villanueva-Perez VL, Monsalve Dolz V, Minguez A. Vulvodynia—an evidence-based literature review and proposed treatment algorithm. Pain Pract. 2016;16(2):204–36. doi:10.1111/papr.12274.. Epub 2015 Jan 12.

    Article  PubMed  Google Scholar 

  15. Goetsch MF. Surgery combined with muscle therapy for dyspareunia from vulvar vestibulitis: an observational study. J Reprod Med. 2007;52(7):597–603.

    PubMed  Google Scholar 

  16. Baggish MS, Miklos JR. Vulvar pain syndrome: a review. Obstet Gynecol Surv. 1995;50(8):618–27.

    Article  CAS  PubMed  Google Scholar 

  17. Andrews JC. Vulvodynia interventions—systematic review and evidence grading. Obstet Gynecol Surv. 2011;66(5):299–315.

    Article  PubMed  Google Scholar 

  18. Tommola P, Unkila-Kallio L, Paavonen J. Surgical treatment of vulvar vestibulitis: a review. Acta Obstet Gynecol Scand. 2010;89(11):1385–95. doi:10.3109/00016349.2010.512071.

    Article  PubMed  Google Scholar 

  19. Woodruff JD, Genadry R, Poliakoff S. Treatment of dyspareunia and vaginal outlet distortions by perineoplasty. Obstet Gynecol. 1981;57(6):750–4.

    CAS  PubMed  Google Scholar 

  20. Bohm-Starke N, Rylander E. Surgery for localized, provoked vestibulodynia: a long-term follow-up study. J Reprod Med. 2008;53(2):83–9.

    PubMed  Google Scholar 

  21. Bergeron S, Binik Y, Khalifé S, Pagidas K, Glazer H. A randomized comparison of group cognitive–behavioral therapy, surface electromyographic biofeedback, and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis. Pain. 2001;91(3):297–306. doi:10.1016/S0304-3959(00)00449-8.

    Article  CAS  PubMed  Google Scholar 

  22. Tommola P, Unkila-Kallio L, Paavonen J. Long-term well-being after surgical or conservative treatment of severe vulvar vestibulitis. Acta Obstet Gynecol Scand. 2012;91(9):1086–93. doi:10.1111/j.1600-0412.2012.01466.x.. Epub 2012 Jul 2.

    Article  PubMed  Google Scholar 

  23. Nunns D, Mandal D, Byrne M, McLelland J, Rani R, Cullimore J, Bansal D, Brackenbury F, Kirtschig G, Wier M. British Society for the Study of Vulval Disease (BSSVD) guideline group. guidelines for the management of vulvodynia. Br J Dermatol. 2010;162(6):1180–5. doi:10.1111/j.1365-2133.2010.09684.x.. Epub 2010 Mar 16.

    Article  CAS  PubMed  Google Scholar 

  24. Reed BD, Haefner HK, Sen A, Gorenflo DW. Vulvodynia incidence and remission rates among adult women: a 2-year follow-up study. Obstet Gynecol. 2008;112(2 Pt 1):231–7. doi:10.1097/AOG.0b013e318180965b.

    Article  PubMed  Google Scholar 

  25. Foster DC, Kotok MB, Huang LS, Watts A, Oakes D, Howard FM, Poleshuck EL, Stodgell CJ, Dworkin RH. Oral desipramine and topical lidocaine for vulvodynia: a randomized controlled trial. Obstet Gynecol. 2010;116(3):583–93. doi:10.1097/AOG.0b013e3181e9e0ab.

    Article  CAS  PubMed  Google Scholar 

  26. Brown CS, Wan J, Bachmann G, Rosen R. Self-management, amitriptyline, and amitripyline plus triamcinolone in the management of vulvodynia. J Womens Health (Larchmt). 2009;18(2):163–9. doi:10.1089/jwh.2007.0676.

    Article  Google Scholar 

  27. Reed BD, Caron AM, Gorenflo DW, Haefner HK. Treatment of vulvodynia with tricyclic antidepressants: efficacy and associated factors. J Low Genit Tract Dis. 2006;10(4):245–51.

    Article  PubMed  Google Scholar 

  28. Pagano R, Wong S. Use of amitriptyline cream in the management of entry dyspareunia due to provoked vestibulodynia. J Low Genit Tract Dis. 2012;16(4):394–7. doi:10.1097/LGT.0b013e3182449bd6.

    Article  PubMed  Google Scholar 

  29. Leo RJ, Dewani S. A systematic review of the utility of antidepressant pharmacotherapy in the treatment of vulvodynia pain. J Sex Med. 2013;10(10):2497–505. doi:10.1111/j.1743-6109.2012.02915.x.. Epub 2012 Sep 13.

    Article  CAS  PubMed  Google Scholar 

  30. Boardman LA, Cooper AS, Blais LR, Raker CA. Topical gabapentin in the treatment of localized and generalized vulvodynia. Obstet Gynecol. 2008;112(3):579–85. doi:10.1097/AOG.0b013e3181827c77.

    Article  PubMed  Google Scholar 

  31. Bergeron S, Khalifé S, Glazer H, Binik Y. Surgical and behavioral treatments for vestibulodynia: two-and-one-half-year follow-up and predictors of outcome. Obstet Gynecol. 2008;111(1):159–66. doi:10.1097/01.AOG.0000295864.76032.a7.

    Article  PubMed  Google Scholar 

  32. Danielsson I, Torstensson T, Brodda-Jansen G, Bohm-Starke N. EMG biofeedback versus topical lidocaine gel: a randomized study for the treatment of women with vulvar vestibulitis. Acta Obstet Gynecol Scand. 2006;85(11):1360–7.

    Article  PubMed  Google Scholar 

  33. Zolnoun DA, Hartmann KE, Steege JF. Overnight 5% lidocaine ointment for treatment of vulvar vestibulitis. Obstet Gynecol. 2003;102(1):84–7.

    CAS  PubMed  Google Scholar 

  34. Segal D, Tifheret H, Lazer S. Submucous infiltration of betamethasone and lidocaine in the treatment of vulvar vestibulitis. Eur J Obstet Gynecol Reprod Biol. 2003 Mar 26;107(1):105–6.

    Article  PubMed  Google Scholar 

  35. Murina F, Tassan P, Roberti P, Bianco V. Treatment of vulvar vestibulitis with submucous infiltrations of methylprednisolone and lidocaine. An alternative approach. J Reprod Med. 2001;46(8):713–6.

    CAS  PubMed  Google Scholar 

  36. McDonald JS, Rapkin AJ. Multilevel local anesthetic nerve blockade for the treatment of generalized vulvodynia: a pilot study. J Sex Med. 2012;9(11):2919–26. doi:10.1111/j.1743-6109.2012.02909.x.. Epub 2012 Aug 27.

    Article  PubMed  Google Scholar 

  37. Rapkin AJ, McDonald JS, Morgan M. Multilevel local anesthetic nerve blockade for the treatment of vulvar vestibulitis syndrome. Am J Obstet Gynecol. 2008;198(1):41.e1–5 .Epub 2007 Oct 22

    Article  Google Scholar 

  38. Abbott J. The use of botulinum toxin in the pelvic floor for women with chronic pelvic pain-a new answer to old problems? J Minim Invasive Gynecol. 2009;16(2):130–5. doi:10.1016/j.jmig.2008.11.006.. Epub 2009 Jan 22. Review.

    Article  PubMed  Google Scholar 

  39. Petersen CD, Giraldi A, Lundvall L, Kristensen E. Botulinum toxin type A-a novel treatment for provoked vestibulodynia? Results from a randomized, placebo controlled, double blinded study. J Sex Med. 2009;6(9):2523–37. doi:10.1111/j.1743-6109.2009.01378.x.. Epub 2009 Jul 10.

    Article  CAS  PubMed  Google Scholar 

  40. Abbott JA, Jarvis SK, Lyons SD, Thomson A, Vancaille TG. Botulinum toxin type A for chronic pain and pelvic floor spasm in women: a randomized controlled trial. Obstet Gynecol. 2006;108(4):915–23.

    Article  PubMed  Google Scholar 

  41. Bosso JV, Aiken MJ, Simon RA. Successful prevention of local and cutaneous hypersensitivity reactions to seminal fluid with intravaginal cromolyn. Allergy Proc. 1991;12(2):113–6.

    Article  CAS  PubMed  Google Scholar 

  42. Nyirjesy P, Sobel JD, Weitz MV, Leaman DJ, Small MJ, Gelone SP. Cromolyn cream for recalcitrant idiopathic vulvar vestibulitis: results of a placebo controlled study. Sex Transm Infect. 2001;77(1):53–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Murina F, Radici G, Bianco V. Capsaicin and the treatment of vulvar vestibulitis syndrome: a valuable alternative? MedGenMed. 2004;6(4):48.

    PubMed  PubMed Central  Google Scholar 

  44. Steinberg AC, Oyama IA, Rejba AE, Kellogg-Spadt S, Whitmore KE. Capsaicin for the treatment of vulvar vestibulitis. Am J Obstet Gynecol. 2005;192(5):1549–53.

    Article  CAS  PubMed  Google Scholar 

  45. Bouchard C, Brisson J, Fortier M, Morin C, Blanchette C. Use of oral contraceptive pills and vulvar vestibulitis: a case-control study. Am J Epidemiol. 2002;156(3):254–61.

    Article  PubMed  Google Scholar 

  46. Edgardh K, Abdelnoor M. Vulvar vestibulitis and risk factors: a population-based case-control study in Oslo. Acta Derm Venereol. 2007;87(4):350–4.

    Article  PubMed  Google Scholar 

  47. Lee M, Morgan M, Rapkin A. Clitoral and vulvar vestibular sensation in women taking 20 mcg ethinyl estradiol combined oral contraceptives: a preliminary study. J Sex Med. 2011;8(1):213–8. doi:10.1111/j.1743-6109.2010.02074.x.. Epub 2010 Oct 18.

    Article  CAS  PubMed  Google Scholar 

  48. Burrows LJ, Goldstein AT. The treatment of vestibulodynia with topical estradiol and testosterone. Sex Med. 2013;1(1):30–3. doi:10.1002/sm2.4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Goldstein A, Burrows L, Goldstein I. Can oral contraceptives cause vestibulodynia? J Sex Med. 2010;7(4 Pt 1):1585–7.

    Article  PubMed  Google Scholar 

  50. Simonelli C, Eleuteri S, Petruccelli F, Rossi R. Female sexual pain disorders: dyspareunia and vaginismus. Curr Opin Psychiatry. 2014;27(6):406–12.

    Article  PubMed  Google Scholar 

  51. Reissing ED, Brown C, Lord MJ, Binik YM, Khalifé S. Pelvic floor muscle functioning in women with vulvar vestibulitis syndrome. J Psychosom Obstet Gynaecol. 2005;26(2):107–13.

    Article  CAS  PubMed  Google Scholar 

  52. Bortolami A, Vanti C, Banchelli F, Guccione AA, Pillastrini P. Relationship between female pelvic floor dysfunction and sexual dysfunction: an observational study. J Sex Med. 2015;12(5):1233–41. doi:10.1111/jsm.12882.. Epub 2015 Apr 8.

    Article  PubMed  Google Scholar 

  53. Albrecht KB. “How-To” guide to pelvic floor muscle dysfunction. Clin Obstet Gynecol. 2015;58(3):546–50. doi:10.1097/GRF.0000000000000135.

    Article  PubMed  Google Scholar 

  54. Hong CZ, Simons DG. Pathophysiologic and electrophysiologic mechanisms of myofascial trigger points. Arch Phys Med Rehabil. 1998;79(7):863–72.

    Article  CAS  PubMed  Google Scholar 

  55. Haefner HK, Collins ME, Davis GD, Edwards L, Foster DC, Hartmann ED, Kaufman RH, Lynch PJ, Margesson LJ, Moyal-Barracco M, Piper CK, Reed BD, Stewart EG, Wilkinson EJ. The vulvodynia guideline. J Low Genit Tract Dis. 2005;9(1):40–51.

    Article  PubMed  Google Scholar 

  56. Goldfinger C, Pukall CF, Gentilcore-Saulnier E, McLean L, Chamberlain S. A prospective study of pelvic floor physical therapy: pain and psychosexual outcomes in provoked vestibulodynia. J Sex Med. 2009;6(7):1955–68.

    Article  PubMed  Google Scholar 

  57. Goldfinger C, Pukall CF, Thibault-Gagnon S, McLean L, Chamberlain S. Effectiveness of cognitive-behavioral therapy and physical therapy for provoked vestibulodynia: a randomized pilot study. J Sex Med. 2016;13(1):88–94.

    Article  PubMed  Google Scholar 

  58. Gentilcore-Saulnier E, McLean L, Goldfinger C, Pukall CF, Chamberlain S. Pelvic floor muscle assessment outcomes in women with and without provoked vestibulodynia and the impact of a physical therapy program. J Sex Med. 2010;7(2 Pt 2).

    Google Scholar 

  59. Bergeron S, Brown C, Lord MJ, Oala M, Binik YM, Khalifé S. Physical therapy for vulvar vestibulitis syndrome: a retrospective study. J Sex Marital Ther. 2002;28(3):183–92.

    Article  PubMed  Google Scholar 

  60. Glazer HI, Rodke G, Swencionis C, Hertz R, Young AW. Treatment of vulvar vestibulitis syndrome with electromyographic biofeedback of pelvic floor musculature. J Reprod Med. 1995;40(4):283–90.

    CAS  PubMed  Google Scholar 

  61. Glazer HI. Dysesthetic vulvodynia. Long-term follow-up after treatment with surface electromyography-assisted pelvic floor muscle rehabilitation. J Reprod Med. 2000;45(10):798–802.

    CAS  PubMed  Google Scholar 

  62. McKay E, Kaufman RH, Doctor U, Berkova Z, Glazer H, Redko V. Treating vulvar vestibulitis with electromyographic biofeedback of pelvic floor musculature. J Reprod Med. 2001;46(4):337–42.

    CAS  PubMed  Google Scholar 

  63. Murina F, Bianco V, Radici G, Felice R, Di Martino M, Nicolini U. Transcutaneous electrical nerve stimulation to treat vestibulodynia: a randomised controlled trial. BJOG. 2008;115(9):1165–70. doi:10.1111/j.1471-0528.2008.01803.x.

    Article  CAS  PubMed  Google Scholar 

  64. Desrochers G, Bergeron S, Khalifé S, Dupuis MJ, Jodoin M. Fear avoidance and self-efficacy in relation to pain and sexual impairment in women with provoked vestibulodynia. Clin J Pain. 2009;25(6):520–7. doi:10.1097/AJP.0b013e31819976e3.

    Article  PubMed  Google Scholar 

  65. Maillé DL, Bergeron S, Lambert B. Body image in women with primary and secondary provoked vestibulodynia: a controlled study. J Sex Med. 2015;12(2):505–15. doi:10.1111/jsm.12765.. Epub 2014 Nov 13.

    Article  PubMed  Google Scholar 

  66. Desrochers G, Bergeron S, Landry T, Jodoin M. Do psychosexual factors play a role in the etiology of provoked vestibulodynia? A critical review. J Sex Marital Ther. 2008;34(3):198–226. doi:10.1080/00926230701866083.

    Article  PubMed  Google Scholar 

  67. Smith KB, Pukall CF. A systematic review of relationship adjustment and sexual satisfaction among women with provoked vestibulodynia. J Sex Res. 2011;48(2–3):166–91. doi:10.1080/00224499.2011.555016.

    Article  PubMed  Google Scholar 

  68. Pâquet M, Bois K, Rosen NO, Mayrand MH, Charbonneau-Lefebvre V, Bergeron S. Why us? perceived injustice is associated with more sexual and psychological distress in couples coping with genito-pelvic pain. J Sex Med. 2016;13(1):79–87. doi:10.1016/j.jsxm.2015.11.007.

    Article  PubMed  Google Scholar 

  69. Jackson B, Kubzansky L, Wright R, Rosalind J. Linking perceived unfairness to physical health: the perceived unfairness model. Rev Gen Psychol. 2006;10(1):21–40. doi:10.1037/1089-2680.10.1.21.

    Article  Google Scholar 

  70. Rosenbaum TY, Barnard E, Wilhite M. Psychosexual aspects of vulvar disease. Clin Obstet Gynecol. 2015;58(3):551–5. doi:10.1097/GRF.0000000000000136.

    Article  PubMed  Google Scholar 

  71. Masheb RM, Kerns RD, Lozano C, Minkin MJ, Richman S. A randomized clinical trial for women with vulvodynia: cognitive-behavioral therapy vs. supportive psychotherapy. Pain. 2009;141(1–2):31–40. doi:10.1016/j.pain.2008.09.031.. Epub 2008 Nov 20.

    Article  PubMed  Google Scholar 

  72. Desrochers G, Bergeron S, Khalifé S, Dupuis MJ, Jodoin M. Provoked vestibulodynia: psychological predictors of topical and cognitive-behavioral treatment outcome. Behav Res Ther. 2010;48(2):106–15. doi:10.1016/j.brat.2009.09.014.. Epub 2009 Oct 7.

    Article  PubMed  Google Scholar 

  73. Corsini-Munt S, Bergeron S, Rosen NO, Mayrand MH, Delisle I. Feasibility and preliminary effectiveness of a novel cognitive-behavioral couple therapy for provoked vestibulodynia: a pilot study. J Sex Med. 2014;11(10):2515–27.

    Article  PubMed  Google Scholar 

  74. Lindström S, Kvist LJ. Treatment of provoked vulvodynia in a Swedish cohort using desensitization exercises and cognitive behavioral therapy. BMC Womens Health. 2015;15:108. doi:10.1186/s12905-015-0265-3.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Weijmar Schultz WC, Gianotten WL, van der Meijden WI, van de Wiel HB, Blindeman L, Chadha S, Drogendijk AC. Behavioral approach with or without surgical intervention to the vulvar vestibulitis syndrome: a prospective randomized and non-randomized study. J Psychosom Obstet Gynaecol. 1996;17(3):143–8.

    Article  CAS  PubMed  Google Scholar 

  76. Bishop S, Lau M, Shapiro S, Carlson L, Anderson N, Carmody J, Segal Z, Abbey S, Specca M, Velging D, Devins G. Mindfulness: a proposed operational definition. Clin Psychol. 2004;11(3):230–41. doi:10.1093/clipsy.bph077.

    Google Scholar 

  77. Brotto LA, Basson R. Group mindfulness-based therapy significantly improves sexual desire in women. Behav Res Ther. 2014;57:43–54. doi:10.1016/j.brat.2014.04.001.. Epub 2014 Apr 18.

    Article  PubMed  Google Scholar 

  78. Brotto L, Basson R, Smith K, Driscoll M, Sadownik L. Mindfulness-based Group therapy for women with provoked vestibulodynia. Mindfulness. 2015;6(3):417–32.

    Article  Google Scholar 

  79. Pukall C, Kandyba K, Amsel R, Khalifé S, Binik Y. Effectiveness of hypnosis for the treatment of vulvar vestibulitis syndrome: a preliminary investigation. J Sex Med. 2007;4(2):417–25.

    Article  PubMed  Google Scholar 

  80. Rosen NO, Bergeron S, Leclerc B, Lambert B, Steben M. Woman and partner-perceived partner responses predict pain and sexual satisfaction in provoked vestibulodynia (PVD) couples. J Sex Med. 2010;7(11):3715–24. doi:10.1111/j.1743-6109.2010.01957.x.

    Article  PubMed  Google Scholar 

  81. Sheppard C, Hallam-Jones R, Wylie K. Why have you both come? Emotional, relationship, sexual and social issues raised by heterosexual couples seeking sexual therapy (in women referred to a sexual difficulties clinic with a history of vulval pain). Sex Relat Ther. 2008;23(3):217–26. doi:10.1080/14681990802227974.

    Article  Google Scholar 

  82. Awada N, Bergeron S, Steben M, Hainault VA, McDuff P. To say or not to say: dyadic ambivalence over emotional expression and its associations with pain, sexuality, and distress in couples coping with provoked vestibulodynia. J Sex Med. 2014;11(5):1271–82. doi:10.1111/jsm.12463.. Epub 2014 Feb 19.

    Article  PubMed  Google Scholar 

  83. Desrosiers M, Bergeron S, Meana M, Leclerc B, Binik YM, Khalifé S. Psychosexual characteristics of vestibulodynia couples: partner solicitousness and hostility are associated with pain. J Sex Med. 2008;5(2):418–27 .Epub 2007 Dec 17

    Article  PubMed  Google Scholar 

  84. Lemieux AJ, Bergeron S, Steben M, Lambert B. Do romantic partners’ responses to entry dyspareunia affect women’s experience of pain? The roles of catastrophizing and self-efficacy. J Sex Med. 2013;10(9):2274–84. doi:10.1111/jsm.12252.. Epub 2013 Jun 27.

    Article  PubMed  Google Scholar 

  85. Rosen NO, Bergeron S, Glowacka M, Delisle I, Baxter ML. Harmful or helpful: perceived solicitous and facilitative partner responses are differentially associated with pain and sexual satisfaction in women with provoked vestibulodynia. J Sex Med. 2012;9(9):2351–60. doi:10.1111/j.1743-6109.2012.02851.x.. Epub 2012 Jul 19.

    Article  PubMed  Google Scholar 

  86. Bois K, Bergeron S, Rosen NO, McDuff P, Grégoire C. Sexual and relationship intimacy among women with provoked vestibulodynia and their partners: associations with sexual satisfaction, sexual function, and pain self-efficacy. J Sex Med. 2013;10(8):2024–35. doi:10.1111/jsm.12210.. Epub 2013 Jun 26.

    Article  PubMed  Google Scholar 

  87. Boerner KE, Rosen NO. Acceptance of vulvovaginal pain in women with provoked vestibulodynia and their partners: associations with pain, psychological, and sexual adjustment. J Sex Med. 2015;12(6):1450–62. doi:10.1111/jsm.12889.. Epub 2015 Apr 13.

    Article  PubMed  Google Scholar 

  88. Rosen NO, Bergeron S, Sadikaj G, Delisle I. Daily associations among male partner responses, pain during intercourse, and anxiety in women with vulvodynia and their partners. J Pain. 2015;16(12):1312–20. doi:10.1016/j.jpain.2015.09.003.. Epub 2015 Sep 25.

    Article  PubMed  Google Scholar 

  89. Corsini-Munt S, Bergeron S, Rosen NO, Steben M, Mayrand MH, Delisle I, McDuff P, Aerts L, Santerre-Baillargeon M. A comparison of cognitive-behavioral couple therapy and lidocaine in the treatment of provoked vestibulodynia: study protocol for a randomized clinical trial. Trials. 2014;15:506.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Schlaeger JM, Xu N, Mejta CL, Park CG, Wilkie DJ. Acupuncture for the treatment of vulvodynia: a randomized wait-list controlled pilot study. J Sex Med. 2015;12(4):1019–27. doi:10.1111/jsm.12830.. Epub 2015 Jan 30.

    Article  PubMed  Google Scholar 

  91. Backman H, Widenbrant M, Bohm-Starke N, Dahlof LG. Combined physical and psychosexual therapy for provoked vestibulodynia-an evaluation of a multidisciplinary treatment model. J Sex Res. 2008;45(4):378–85. doi:10.1080/00224490802398365.

    Article  PubMed  Google Scholar 

  92. Spoelstra SK, Dijkstra JR, van Driel MF, Weijmar Schultz WC. Long-term results of an individualized, multifaceted, and multidisciplinary therapeutic approach to provoked vestibulodynia. J Sex Med. 2011;8(2):489–96. doi:10.1111/j.1743-6109.2010.01941.x.

    Article  PubMed  Google Scholar 

  93. Brotto LA, Yong P, Smith KB, Sadownik LA. Impact of a multidisciplinary vulvodynia program on sexual functioning and dyspareunia. J Sex Med. 2015;12(1):238–47. doi:10.1111/jsm.12718.. Epub 2014 Oct 30.

    Article  PubMed  Google Scholar 

  94. Lahaie MA, Amsel R, Khalifé S, Boyer S, Faaborg-Andersen M, Binik YM. Can fear, pain, and muscle tension discriminate vaginismus from dyspareunia/provoked vestibulodynia? Implications for the new DSM-5 diagnosis of genito-pelvic pain/penetration disorder. Arch Sex Behav. 2015;44(6):1537–50. doi:10.1007/s10508-014-0430-z.. Epub 2014 Nov 15.

    Article  PubMed  Google Scholar 

  95. Pacik PT. Understanding and treating vaginismus: a multimodal approach. Int Urogynecol J. 2014;25(12):1613–20. doi:10.1007/s00192-014-2421-y.. Epub 2014 Jun 4.

    Article  PubMed  Google Scholar 

  96. Shifren JL, Johannes CB, Monz BU, Russo PA, Bennett L, Rosen R. Help-seeking behavior of women with self-reported distressing sexual problems. J Womens Health (Larchmt). 2009;18(4):461–8. doi:10.1089/jwh.2008.1133.

    Article  Google Scholar 

  97. Melnik T, Hawton K, McGuire H. Interventions for vaginismus. Cochrane Database Syst Rev. 2012;12:CD001760. doi:10.1002/14651858.CD001760.pub2.

    PubMed  Google Scholar 

  98. Pacik PT. Vaginismus: review of current concepts and treatment using botox injections, bupivacaine injections, and progressive dilation with the patient under anesthesia. Aesthetic Plast Surg. 2011;35(6):1160–4. doi:10.1007/s00266-011-9737-5.. Epub 2011 May 10. Review.

    Article  PubMed  Google Scholar 

  99. Macey K, Gregory A, Nunns D, das Nair R. Women’s experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study. BMC Womens Health. 2015;20(15):49. doi:10.1186/s12905-015-0201-6.

    Article  Google Scholar 

  100. Schnyder U, Schnyder-Lüthi C, Ballinari P, Blaser A. Therapy for vaginismus: in vivo versus in vitro desensitization. Can J Psychiatry. 1998;43(9):941–4.

    Article  CAS  PubMed  Google Scholar 

  101. ter Kuile MM, Melles RJ, Tuijnman-Raasveld CC, de Groot HE, van Lankveld JJ. Therapist-aided exposure for women with lifelong vaginismus: mediators of treatment outcome: a randomized waiting list control trial. J Sex Med. 2015;12(8):1807–19. doi:10.1111/jsm.12935.. Epub 2015 Aug 6.

    Article  PubMed  Google Scholar 

  102. Lahaie MA, Boyer SC, Amsel R, Khalifé S, Binik YM. Vaginismus: a review of the literature on the classification/diagnosis, etiology and treatment. Womens Health (Lond). 2010;6(5):705–19. doi:10.2217/whe.10.46.

    Article  Google Scholar 

  103. Ferreira JR, Souza RP. Botulinum toxin for vaginismus treatment. Pharmacology. 2012;89(5–6):256–9.

    Article  CAS  PubMed  Google Scholar 

  104. Ghazizadeh S, Nikzad M. Botulinum toxin in the treatment of refractory vaginismus. Obstet Gynecol. 2004;104(5 Pt 1):922.

    Article  CAS  PubMed  Google Scholar 

  105. Bertolasi L, Frasson E, Cappelletti JY, Vicentini S, Bordignon M, Graziottin A. Botulinum neurotoxin type A injections for vaginismus secondary to vulvar vestibulitis syndrome. Obstet Gynecol. 2009;114(5):1008–16. doi:10.1097/AOG.0b013e3181bb0dbb.

    Article  CAS  PubMed  Google Scholar 

  106. ter Kuile MM, Weijenborg PT. A cognitive-behavioral group program for women with vulvar vestibulitis syndrome (VVS): factors associated with treatment success. J Sex Marital Ther. 2006;32(3):199–213.

    Article  PubMed  Google Scholar 

  107. Engman M, Wijma K, Wijma B. Long-term coital behaviour in women treated with cognitive behaviour therapy for superficial coital pain and vaginismus. Cogn Behav Ther. 2010;39(3):193–202. doi:10.1080/16506070903571014.

    Article  PubMed  Google Scholar 

  108. ter Kuile MM, van Lankveld JJ, de Groot E, Melles R, Neffs J, Zandbergen M. Cognitive-behavioral therapy for women with lifelong vaginismus: process and prognostic factors. Behav Res Ther. 2007;45(2):359–73.

    Article  PubMed  Google Scholar 

  109. Akhavan-Taghavi MH, Asghari-Moghaddam MA, Froutan SK, Jadid-Milani M. Vaginismus in Iran: a single center report of 7 years experience. Nephrourol Mon. 2015;7(6):e30077. doi:10.5812/numonthly.30077.. eCollection 2015.

    Article  PubMed  PubMed Central  Google Scholar 

  110. Munasinghe T, Goonaratna C, de Silva P. Couple characteristics and outcome of therapy in vaginismus. Ceylon Med J. 2004;49(2):54–7.

    PubMed  Google Scholar 

  111. Ben-Zion I, Rothschild S, Chudakov M, Aloni R. Surrogate versus couple therapy in vaginismus. J Sex Med. 2007;4(3):728–33.

    Article  PubMed  Google Scholar 

  112. Labat JJ, Riant T, Robert R, Amarenco G, Lefaucheur JP, Rigaud J. Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria). Neurourol Urodyn. 2008;27(4):306–10.

    Article  PubMed  Google Scholar 

  113. Carmel M, Lebel M, Tu le M. Pudendal nerve neuromodulation with neurophysiology guidance: a potential treatment option for refractory chronic pelvi-perineal pain. Int Urogynecol J. 2010;21(5):613–6. doi:10.1007/s00192-009-1054-z.. Epub 2009 Dec 12.

    Article  PubMed  Google Scholar 

  114. Robert R, Labat JJ, Bensignor M, Glemain P, Deschamps C, Raoul S, Hamel O. Decompression and transposition of the pudendal nerve in pudendal neuralgia: a randomized controlled trial and long-term evaluation. Eur Urol. 2005;47(3):403–8.

    Article  PubMed  Google Scholar 

  115. Lee A, Bradford J, Fischer G. Long-term management of adult vulvar lichen sclerosus: a prospective cohort study of 507 women. JAMA Dermatol. 2015;151(10):1061–7. doi:10.1001/jamadermatol.2015.0643.

    Article  PubMed  Google Scholar 

  116. Chi CC, Kirtschig G, Baldo M, Brackenbury F, Lewis F, Wojnarowska F. Topical interventions for genital lichen sclerosus. Cochrane Database Syst Rev. 2011;7(12):CD008240. doi:10.1002/14651858.CD008240.pub2.

    Google Scholar 

  117. Burrows LJ, Creasey A, Goldstein AT. The treatment of vulvar lichen sclerosus and female sexual dysfunction. J Sex Mad. 2011;8(1):219–22.

    Article  Google Scholar 

  118. Goldstein AT, Burrows LJ. Surgical treatment of clitoral phimosis caused by lichen sclerosus. Am J Obstet Gynecol. 2007;196(2):126.e1–4.

    Article  Google Scholar 

  119. Gurumurthy M, Morah N, Gioffre G, Cruickshank ME. The surgical management of complications of vulval lichen sclerosus. Eur J Obstet Gynecol Reprod Biol. 2012;162(1):79–82.

    Article  PubMed  Google Scholar 

  120. Bradford J, Fischer G. Management of vulvovaginal lichen planus: a new approach. J Low Genit Tract Dis. 2013;17(1):28–32.

    Article  PubMed  Google Scholar 

  121. Goldstein A. Perineoplasty and vaginal advancement flap for vulvar granuloma fissuratum. J Sex Med. 2011;8(11):2984–7.

    Article  PubMed  Google Scholar 

  122. Palacios S, Castelo-Branco C, Currie H, Mijatovic V, Nappi RE, Simon J, Rees M. Update on management of genitourinary syndrome of menopause: a practical guide. Maturitas. 2015;82(3):308–13. doi:10.1016/j.maturitas.2015.07.020.. Epub 2015 Jul 26.

    Article  PubMed  Google Scholar 

  123. Palma F, Volpe A, Villa P, Cagnacci A, Writing group of AGATA study. Vaginal of women in postmenopause. Results from a multicentric observational study: The AGATA study atrophy. Maturitas. 2016;83:40–4.

    Article  CAS  PubMed  Google Scholar 

  124. North American Menopause Society. Management of symptomatic vulvovaginal atrophy: 2013 position statement of The American Menopause Society. Menopause. 2013;20(9):888–902.

    Article  Google Scholar 

  125. Suckling J, Lethaby A, Kennedy R. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev. 2006;4:CD001500.

    Google Scholar 

  126. American College of Obstetricians and Gynecologists Committee Opinion. The Use of Vaginal Estrogen in Women With a History of Estrogen-Dependent Breast Cancer Number 659, March 2016 p. 618–9.

    Google Scholar 

  127. Simon JA, Lin VH, Radovich C, Bachmann GA, Ospemifene Study Group. One-year long-term safety extension study of ospemifene for the treatment of vulvar and vaginal atrophy in postmenopausal women with a uterus. Menopause. 2013;20(4):418–27. doi:10.1097/gme.0b013e31826d36ba.

    PubMed  Google Scholar 

  128. Portman DJ, Labrie F, Archer DF, Bouchard C, Cusan L, Girard G, Ayotte N, Koltun W, Blouin F, Young D, Wade A, Martel C, Dubé R, Other participating members of VVA Prasterone Group. Lack of effect of intravaginal dehydroepiandrosterone (DHEA, prasterone) on the endometrium in postmenopausal women. Menopause. 2015;22(12):1289–95.

    Article  PubMed  Google Scholar 

  129. Goetsch MF, Lim JY, Caughey AB. A practical solution for dyspareunia in breast cancer survivors: a randomized controlled trial. J Clin Oncol. 2015;33(30):3394–400.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  130. Perino A, Calligaro A, Forlani F, Tiberio C, Cucinella G, Svelato A, Saitta S, Calagna G. Vulvo-vaginal atrophy: a new treatment modality using thermo-ablative fractional CO2 laser. Maturitas. 2015;80(3):296–301.

    Article  PubMed  Google Scholar 

  131. Zondervan KT, Yudkin PL, Vessey MP, Jenkinson CP, Dawes MG, Barlow DH, Kennedy SH. Chronic pelvic pain in the community – symptoms, investigations, and diagnoses. Am J Obstet Gynecol. 2001;184(6):1149–55.

    Article  CAS  PubMed  Google Scholar 

  132. Diatchenko L, Nackley AG, Slade GD, Fillingim RB, Maixner W. Idiopathic pain disorders – pathways of vulnerability. Pain. 2006;123(3):226–30.

    Article  PubMed  Google Scholar 

  133. Stratton P, Khachikyan I, Sinaii N, Ortiz R, Shah J. Association of chronic pelvic pain and endometriosis with signs of sensitization and myofascial pain. Obstet Gynecol. 2015;125(3):719–28.

    Article  PubMed  PubMed Central  Google Scholar 

  134. As-Sanie S, Kim J, Schmidt-Wilcke T, Sundgren PC, Clauw DJ, Napadow V, Harris RE. Functional connectivity is associated with altered brain chemistry in women with endometriosis-associated chronic pelvic pain. J Pain. 2016;17(1):1–13. doi:10.1016/j.jpain.2015.09.008.. Epub 2015 Oct 9.

    Article  CAS  PubMed  Google Scholar 

  135. Brawn J, Morotti M, Zondervan KT, Becker CM, Vincent K. Central changes associated with chronic pelvic pain and endometriosis. Hum Reprod Update. 2014;20(5):737–47.

    Article  PubMed  PubMed Central  Google Scholar 

  136. Kavoussi SK, Lim CS, Skinner BD, Lebovic DI, As-Sanie S. New paradigms in the diagnosis and management of endometriosis. Curr Opin Obstet Gynecol. 2016;28(4):267–76.

    Article  PubMed  Google Scholar 

  137. Prentice A, Deary AJ, Bland E. Progestagens and anti-progestagens for pain associated with endometriosis. Cochrane Database Syst Rev. 2000;CD002122.

    Google Scholar 

  138. Brown J, Pan A, Hart RJ. Gonadotrophin-releasing hormone analogues for pain associated with endometriosis. Cochrane Database Syst Rev. 2010;8(12):CD008475.

    Google Scholar 

  139. Ferrero S, Gillott DJ, Venturini PL, Remorgida V. Use of aromatase inhibitors to treat endometriosis-related pain symptoms: a systematic review. Reprod Biol Endocrinol. 2011;9:89. doi:10.1186/1477-7827-9-89.

    Article  PubMed  PubMed Central  Google Scholar 

  140. Muzii L, Di Tucci C, Achilli C, Di Donato V, Musella A, Palaia I, Panici PB. Continuous versus cyclic oral contraceptives after laparoscopic excision of ovarian endometriomas: a systematic review and metaanalysis. Am J Obstet Gynecol. 2016;214(2):203–11.

    Article  CAS  PubMed  Google Scholar 

  141. Deguara CS, Pepas L, Davis C. Does minimally invasive surgery for endometriosis improve pelvic symptoms and quality of life? Curr Opin Obstet Gynecol. 2012;24(4):241–4.

    Article  PubMed  Google Scholar 

  142. Fritzer N, Hudelist G. Love is a pain? Quality of sex life after surgical resection of endometriosis: a review. Eur J Obstet Gynecol Reprod Biol. 2016. pii: S0301-2115(16)30187-7.

    Google Scholar 

  143. Lukic A, Di Properzio M, De Carlo S, Nobili F, Schimberni M, Bianchi P, Prestigiacomo C, Moscarini M, Caserta D. Quality of sex life in endometriosis patients with deep dyspareunia before and after laparoscopic treatment. Arch Gynecol Obstet. 2016;293(3):583–90. doi:10.1007/s00404-015-3832-9.. Epub 2015 Aug 6.

    Article  CAS  PubMed  Google Scholar 

  144. Nourmoussavi M, Bodmer-Roy S, Mayji N, Williams C, ALlaire C, Yong PJ. Bladder base tenderness in etiology of deep dyspareunia. J Sex Med. 2014;12:3078–84.

    Article  Google Scholar 

  145. Peters KM, Killinger KA, Carrico DJ, Ibrahim IA, Diokno AC, Grasiottin A. Sexual function and sexual distress in women with interstitial cystitis a case control study. Urology. 2007;70(3):543–7.

    Article  PubMed  Google Scholar 

  146. Mathias SD, Kuppermann M, Liberman RF, et al. Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol. 1996;87:321Y327.

    Article  Google Scholar 

  147. Doggweiler R, Whitmore KE, Meijlink JM, Drake MJ, Frawley H, Nordling J, Hanno P, Fraser MO, Homma Y, Garrido G, Gomes MJ, Elneil S, van de Merwe JP, Lin AT, Tomoe H. A standard for terminology in chronic pelvic pain syndromes: a report from the chronic pelvic pain working group of the international continence society. NeurourolUrodyn. 2016. doi:10.1002/nau.23072.. [Epub ahead of print].

    Google Scholar 

  148. Bogart LM, Suttorp MJ, Elliott MN, Clemens JQ, Berry SH. Prevalence and correlates of sexual dysfunction among women with bladder pain sydrome/interstitial cystitis. Female Urology. 2011;77(3):576–80.

    Article  PubMed  Google Scholar 

  149. Graziottin A. Sexual pain disorders: dyspareunia and vaginismus. Oxford: Blackwell; 2006. p. P342–35.International Society of Sexual Medicine. Chapter 25

    Google Scholar 

  150. Gardella B, Porru D, Ferdeghini F, Martinotti Gabellotti E, Nappi RE, Rovereto B, Spinillo A. Insight into urogynecologic features of women with interstitial cystitis/painful bladder syndrome. Eur Urol. 2008;54(5):1145–51. doi:10.1016/j.eururo.2008.01.079.. Epub 2008 Feb 6.

    Article  PubMed  Google Scholar 

  151. www.ichelp.org/TreatmentAndSelfHelp/ICAandDiet.html. Accessed 24 Jan 2012.

  152. Fitzgerald MP, Anderson RU, Potts J, Payne CK, Peters KM, Clemens JQ, Kotarinos R, Fraser L, Cosby A, Fortman C, Neville C, Badillo S, Odabachian L, Sanfield A, O’Dougherty B, Halle-Podell R, Cen L, Chuai S, Landis JR, Mickelberg K, Barrell T, Kusek JW, Nyberg LM, Urological Pelvic Pain Collaborative Research Network. Randomized multicenter feasibility trial of myofascial physical therapy for the treatment of urological chronic pelvic pain syndromes. J Urol. 2013;189(1 Suppl):S75–85. doi:10.1016/j.juro.2012.11.018.

    Article  PubMed  Google Scholar 

  153. Hanno PM, Burks DA, Clemens JQ, et al. AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol. 2011;185:2162.

    Article  PubMed  Google Scholar 

  154. Foster Jr HE, Hanno PM, Nickel JC, et al. Effect of amitriptyline on symptoms in treatment naïve patients with interstitial cystitis/painful bladder syndrome. J Urol. 2010;183:1853.

    Article  PubMed  PubMed Central  Google Scholar 

  155. van Ophoven A, Pokupic S, Heinecke A, Hertle L. A prospective, randomized, placebo controlled, double-blind study of amitriptyline for the treatment of interstitial cystitis. J Urol. 2004;172:533.

    Article  PubMed  Google Scholar 

  156. Thilagarajah R, Witherow RO, Walker MM. Oral cimetidine gives effective symptoms relief in painful bladder disease: a prospective, randomized double blind placebo controlled trial. BJU Int. 2001;87:207.

    Article  CAS  PubMed  Google Scholar 

  157. Seshadri P, Emerson L, Morales A. Cimetidine in the treatment of interstitial cystitis. Urology. 1994;44:614.

    Article  CAS  PubMed  Google Scholar 

  158. Dasgupta P, Sharma SD, Womack C, et al. Cimetidine in painful bladder syndrome: a histopathological study. BJU Int. 2001;88:183.

    Article  CAS  PubMed  Google Scholar 

  159. Nickel JC, Herschorn S, Whitmore KE, Forrest JB, Hu P, Friedman AJ, Baseman AS. Pentosan polysulfate sodium for treatment of interstitial cystitis/bladder pain syndrome: insights from a randomized, double-blind, placebo controlled study. J Urol. 2015;193(3):857–62. doi:10.1016/j.juro.2014.09.036.. Epub 2014 Sep 20.

    Article  CAS  PubMed  Google Scholar 

  160. Anderson VR, Perry CM. Pentosan polysulfate: a review of its use in the relief of bladder pain or discomfort in interstitial cystitis. Drugs. 2006;66(6):821–35.

    Article  CAS  PubMed  Google Scholar 

  161. Nickel JC, Parsons CL, Forrest J, Kaufman D, Evans R, Chen A, Wan G, Xiao X. Improvement in sexual functioning in patients with interstitial cystitis/painful bladder syndrome. J Sex Med. 2008;5(2):394–9 .Epub 2007 Dec 14

    Article  PubMed  Google Scholar 

  162. Welk BK, Teichman JM. Dyspareunia response in patients with interstitial cystitis treated withintravesical lidocaine, bicarbonate, and heparin. Urology. 2008;71(1):67–70. doi:10.1016/j.urology.2007.09.067.

    Article  PubMed  Google Scholar 

  163. Ottem DP, Teichman JM. What is the value of cystoscopy with hydrodistension for interstitial cystitis? Urology. 2005;66(3):494–9.

    Article  PubMed  Google Scholar 

  164. Jhang JF, Kuo HC. Novel treatment of chronic bladder pain syndrome and other pelvic pain disorders by Onabotulinumtoxin A injection. Toxins. 2015;7:2232–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  165. Giannantoni A, Conte A, Farfariello V, Proietti S, Vianello A, Nardicchi V, Santoni G, Amantini C. Onabotulinumtoxin-A intradetrusorial injections modulate bladder expression of NGF, TrkA, p75 and TRPV1 in patients with detrusor overactivity. Pharmacol Res. 2013;68(1):118–24. doi:10.1016/j.phrs.2012.11.009.. Epub 2012 Dec 13.

    Article  CAS  PubMed  Google Scholar 

  166. Conte A, Giannantoni A, Proietti S, Giovannozzi S, Fabbrini G, Rossi A, Porena M, Berardelli A. Botulinum toxin A modulates afferent fibers in neurogenic detrusor overactivity. Eur J Neurol. 2012;19(5):725–32. doi:10.1111/j.1468-1331.2011.03618.x.. Epub 2011 Dec 28.

    Article  CAS  PubMed  Google Scholar 

  167. Kaya S, Hermans L, Willems T, Roussel N, Meeus M. Central sensitization in urogynecological chronic pelvic pain: A systematic literature review. Pain Physician. 2013;16:291–308.

    PubMed  Google Scholar 

  168. Aoki KR. Evidence for antinociceptive activity of botulinum toxin type A in pain management. Headache. 2003;43(Suppl 1):S9–15.

    Article  PubMed  Google Scholar 

  169. Foran PG, Mohammed N, Lisk GO, Nagwaney S, Lawrence GW, Johnson E, Smith L, Aoki KR, Dolly JO. Evaluation of the therapeutic usefulness of botulinum neurotoxin B, C1, E, and F compared with the long lasting type A. Basis for distinct durations of inhibition of exocytosis in central neurons. J Biol Chem. 2003;278(2):1363–71 .Epub 2002 Oct 14

    Article  CAS  PubMed  Google Scholar 

  170. Durham PL, Cady R, Cady R. Regulation of calcitonin gene-related peptide secretion from trigeminal nerve cells by botulinum toxin type A: implications for migraine therapy. Headache. 2004;44(1):35–42 .discussion 42-3

    Article  PubMed  Google Scholar 

  171. Khera M, Somogyi GT, Kiss S, Boone TB, Smith CP. Botulinum toxin A inhibits ATP release from bladder urothelium after chronic spinal cord injury. Neurochem Int. 2004;45(7):987–93.

    Article  CAS  PubMed  Google Scholar 

  172. Nijs J, van Houdenhove B, Oostendorp RA. Recognition of central sensitization in patients with musculoskeletal pain: application of pain neurophysiology in manual therapy practice. Man Ther. 2010;15(2):135–41. doi:10.1016/j.math.2009.12.001.. Epub 2009 Dec 24.

    Article  PubMed  Google Scholar 

  173. Kuo HC, Chancellor MB. Comparison of intravesical botulinum toxin type A injections plus hydrodistention with hydrodistention alone for the treatment of refractory interstitial cystitis/painful bladder syndrome. BJU Int. 2009;104(5):657–61. doi:10.1111/j.1464-410X.2009.08495.x.. Epub 2009 Mar 30.

    Article  CAS  PubMed  Google Scholar 

  174. Kuo HC, Jiang YH, Tsai YC, Kuo YC. Intravesical botulinum toxin-A injection reduce bladder pain of interstital cystitis/bladder pain syndrome refractory to conventional treatment—A prospective, multicenter, randomized, double blind, placebo-controlled clinical trial. NeurourolUrodyn. 2016;35(5):609–14. doi:10.1002/nau.22760.. Epub 2015 Apr 24.

    CAS  Google Scholar 

  175. Marcelissen T, Jacobs R, van Kerrebroeck P, de Wachter S. Sacral neuromodulation as a treatment for chronic pelvic pain review article. J Urol. 2011;186(2):387–93.

    Article  CAS  PubMed  Google Scholar 

  176. Lombardi G, Finazzi Agrò E, Del Popolo G. Sacral neuromodulation and female sexuality. Int Urogynecol J. 2015;26(12):1751–7. doi:10.1007/s00192-015-2708-7.. Epub 2015 Apr 16.

    Article  PubMed  Google Scholar 

  177. Fass R, Fullerton S, Naliboff B, Hirsh T. Mayer EA sexual dysfunction in patients with irritable bowel syndrome and non-ulcer dyspepsia. Digestion. 1998;59(1):79–85.

    Article  CAS  PubMed  Google Scholar 

  178. Slocumb J. Neurological factors in chronic pelvic pain: trigger points and the abdominal pelvic pain syndrome. Am J Obstet Gynecol. 1984;149(5):536–43.

    Article  CAS  PubMed  Google Scholar 

  179. Tu FF, Holt J, Gonzales J, Fitzgerald CM. Physical theapy evaluation of patients with chronic pelvic pain: a controlled study. Am J Obstet Gynecol. 2008;198(3):272–7.

    Article  PubMed  Google Scholar 

  180. Mui J, Allaire C, Williams C, Yong PJ. Abdominal wall pain in women with chronic pelvic pain. J Obstet Gynaecol Can. 2016;38(2):154–9.

    Article  PubMed  Google Scholar 

  181. Annaswamy TM, De Luigi AJ, O’Neill BJ, Keole N, Berbrayer D. Emerging concepts in the treatment of myofascial pain: a review of medications, modalities, and needle-based interventions. PMR. 2011;3(10):940–61. doi:10.1016/j.pmrj.2011.06.013.

    Article  Google Scholar 

  182. Nazareno J, Ponich T, Gregor J. Long-term follow-up of trigger point injections for abdominal wall pain. Can J Gastroenterol. 2005;19(9):561–5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of California at Los Angeles (UCLA), Box 951740, 27-139 CHS, Los Angeles, CA, 90095, USA

    Andrea Rapkin

  2. Obstetrics and Gynecology, White Memorial Hospital, Los Angeles, CA, USA

    Salome Masghati

  3. Department of Obstetrics and Gynecology, University of California Los Angeles, Los Angeles, CA, USA

    Tamara Grisales

Authors
  1. Andrea Rapkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Salome Masghati
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tamara Grisales
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrea Rapkin .

Editor information

Editors and Affiliations

  1. Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California, USA

    Waguih William IsHak

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Rapkin, A., Masghati, S., Grisales, T. (2017). Treatment of Genito-Pelvic Pain/Penetration Disorder. In: IsHak, W. (eds) The Textbook of Clinical Sexual Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-52539-6_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-52539-6_21

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-52538-9

  • Online ISBN: 978-3-319-52539-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation