Effectiveness of Cognitive Behavioural Therapy and Physical Therapy for Provoked Vestibulodynia

A Randomized Comparison of Individual Cognitive-behavioural Therapy and Pelvic Floor Rehabilitation in the Treatment of Provoked Vestibulodynia

The purpose of the study was to compare the effectiveness of cognitive behavioural therapy (CBT) and physical therapy (PT) on pain and psychosexual outcomes in women with provoked vestibulodynia (PVD).

Provoked vestibulodynia (PVD) is the most common condition leading to painful intercourse and is currently best understood within a biopsychosocial framework. Although the usefulness of non-medical treatment options for vulvar pain is recognized by many, there is limited research investigating the effectiveness of these treatments using a biopsychosocial approach to outcome measurement. Furthermore, there is little evidence to support the mechanisms by which these treatments lead to pain reduction. This study aimed to address these gaps by investigating two non-medical treatment options: individual cognitive-behavioural therapy (CBT) and physical therapy (PT).

Inclusion Criteria:

• fluent in English
• vulvar pain with attempted vaginal penetration for at least 6 months
• pain limited to vulvar vestibule during cotton swab test

Exclusion Criteria:

• other serious medical, psychiatric, or other pain conditions
• generalized vulvodynia and/or significant vaginismus (i.e., not able to have at least one finger inserted vaginally)
• current pregnancy, breastfeeding, or being less than 6 months postpartum
• unwillingness to abstain from other treatments for their PVD pain during the course of the study