New Developments in the Pathophysiology of Genital Pain: Role of Central Sensitization
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Medically unexplained chronic vulvar pain, or vulvodynia, is a common condition that affects many aspects of a woman’s life. The most common subtype of vulvodynia is provoked vestibulodynia (PVD), and recent research has demonstrated that its pathophysiology likely involves both peripheral and central dysregulation. In this review, the phenomenon of central sensitization is specifically described and linked to relevant findings in the PVD literature. Recommendations for further research in the area of vulvodynia are made, in particular, the examination of other vulvodynia subtypes and of subtypes within the PVD samples. In addition, support is given for the validation of an existing animal model of provoked vulvar pain in order to understand further spinal involvement and also mechanisms involved in the genesis and persistence of this condition.
KeywordsVulvodynia Provoked vestibulodynia Dyspareunia Peripheral sensitization Central factors Central sensitization Pathophysiology Genital pain Sensory innervation Allodynia Hyperalgesia Receptive field expansion GABA Neuronal-glial interactions Nociceptors Pain pathways Quantitative sensory testing Diffuse noxious inhibitory control Functional brain imaging
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Conflict of Interest
Catherine M. Cahill and Caroline F. Pukall declare that they have no conflict of interest.
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This article does not contain any studies with human or animal subjects performed by any of the authors.
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