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“Time is on my side”. Disease trajectory of vulvodynia: a systematic review with a narrative synthesis

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Abstract

Purpose

The aim of this systematic review was to shed light on the disease-trajectory of vulvodynia and identify potential risk factors which may affect such trajectory.

Methods

We searched Pubmed to identify articles providing evidence on vulvodynia trajectory (i.e., remission, relapse or persistence rates) with a minimum follow-up of 2 years. A narrative approach was used for data synthesis.

Results

Four articles were included (total participants: 741 women with vulvodynia; 634 controls). At a 2-year follow-up, 50.6% of women reported remission, remission with relapse was observed in 39.7% and persistence throughout time occurred in 9.6%. A decrease in pain was observed in 71.1% of patients at a 7-year follow-up. Mean pain scores and depressive symptoms resulted lower at 2-year follow-up, whereas sexual function and satisfaction were increased. Factors associated with remission of vulvodynia were greater couple cohesion, decreased reporting of pain after intercourse and lower levels of worst pain. Risk factors for symptom persistence included marriage, more severe pain ratings, depression, pain with partner touch, interstitial cystitis, pain with oral sex, fibromyalgia, older age and anxiety. Recurrence was associated with: longer duration of pain, more severe ratings of the worst pain ever and pain described as provoked.

Conclusions

Symptoms of vulvodynia seem to improve over time, regardless of treatment. This finding contains a key message for patients and their physicians, considering the deleterious consequences of vulvodynia on women’s lives.

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Data availability

Data is available on request.

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Funding

This study was not founded.

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Author notes

  1. G. E. Cetera and C. E. M. Merli contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Gynecology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    G. E. Cetera, C. E. M. Merli, G. Barbara, C. Caia, G. Libutti & V. Boero

  2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    G. E. Cetera, G. Barbara & C. Caia

  3. Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy

    F. Facchin

Authors
  1. G. E. Cetera
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  2. C. E. M. Merli
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  3. F. Facchin
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  4. G. Barbara
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  5. C. Caia
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  6. G. Libutti
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  7. V. Boero
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Contributions

All authors contributed to the literature review for the manuscript. The first draft of the manuscript was written by GEC and CEMM. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

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Correspondence to G. E. Cetera.

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Time is on my side: In: The Rolling Stones No. 2, Decca, London, U.K, 1964.

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Cetera, G.E., Merli, C.E.M., Facchin, F. et al. “Time is on my side”. Disease trajectory of vulvodynia: a systematic review with a narrative synthesis. Arch Gynecol Obstet 309, 1–8 (2024). https://doi.org/10.1007/s00404-023-06984-z

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  • DOI: https://doi.org/10.1007/s00404-023-06984-z

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