PVD Appears For No Obvious Reason


The frustrating thing for someone suffering from PVD is that this condition, which can be excruciatingly painful and deeply distressing, usually comes on for no apparent reason. The symptoms are all too real, but they don't make sense to the patient or her partner because there's no sign of the usual causes of pain and discomfort in the genitals, such as infection or trauma.

So far, the causes of PVD are hard to trace. Estimates about how common it is range from very rare to ten per cent of the female population. The truth is most likely somewhere in-between. My colleagues and I, working at the Pain Laboratory at the Siena Medical School in Italy, have been investigating PVD for more than five years. Initially, it looked like PVD could be caused by repeated infections or stress, or even genetic history. But, as our research has gone on, we’ve come to think that there may be no types of woman more prone to PVD than others. In patients who suffer from this condition, the history of pregnancy or other gynecological events is totally normal, and we don’t see any greater history of promiscuity or risk-taking behavior. Additionally, women who suffer from PVD don’t seem to get genital infections more often than women who don’t. The only exception worth noting in this context is the “association” of PVD, which is a syndrome of chronic pelvic pain, with other syndromes of chronic pain such as Interstitial Cystitis and Fibromyalgia.

So PVD is an unpredictable enemy. The first attack can happen at any age. We have seen girls in their teens experience PVD pain the first time they try to have sexual intercourse, but we also treat women who got PVD for the first time after menopause.

I recently treated a 24-year old patient, who was engaged but “unfortunately still a virgin” (her words). She had experienced intense pain all over her body since when she could remember. A pinch from her brother would make her cry; a spank from Mother would sting until the next day. Often, she was too tired to go out and play with the other children. Her Mother scolded her, saying she complained too much and the girl believed her. “How did I know what other girls felt?” she said. “I just thought I was a complainer; just too sensitive!” Only when she began adulthood did she realize that her experiences were not normal, prompting her to look for answers. Luckily, she was referred to our Pain Lab and, not surprisingly, she was diagnosed with Fibromyalgia. Learning more about the syndromes of chronic pain, she felt encouraged to seek counseling for pain during attempted intercourse. She came to see me and was diagnosed with PVD. As a positive person, she felt it was a good opportunity to get better, and so far has embraced the recommended treatment enthusiastically.


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