10#Things#You#
(And#your#Health#Care#Provider)#
Should#Know#About#
Vulvodynia,#Vestibulodynia,#Pain#and#your#Brain#
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by Alisa Pascale, MS, WHNP-BC
January 2014
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Vulvodynia!is!a!term!used!to!describe!chronic!pain!or!discomfort!of!the!vulva!or!vestibule!in!the!
absence!of!other!anatomic!findings. Whether!you!have!been!recently!diagnosed!with!
vulvodynia!or!vestibulodynia,!or!have!been!suffering!for!many!years!from!one!of!these!
conditions,!recent!research!on!the!brain,!vulvar!pain,!and!chronic!pain!in!general!may!help!you!
find!new!ways!to!think!about,!manage!and!treat!your!condition.!
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This!fact!sheet!summarizes!some!of!the!recent!cutting!edge!research!on!vulvodynia,!
vestibulodynia,!pain!and!your!brain.!!Rather!than!looking!at!vulvodynia!and!vestibulodynia!as!
“all!in!your!head”!OR!“all!in!your!vulva,”!its!underlying!cause!is!better!understood!within!the!
system!of!mindBbrainBbody!interactions!related!to!genetic!and!psychosocial!risk!factors,!
biological!and/or!infectious!triggers,!coping!skills,!and!personality!traits!that!affect!how!the!
brain!is!able!to!perceive,!process!and!manage!pain.!!Hopefully!this!information!will!help!you!
better!understand!your!condition,!improve!your!coping,!and!open!you!to!greater!avenues!of!
support!that!will!lead!to!successful!treatment.!
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1. What'does'Vulvodynia'have'to'do'with'my'Brain?'
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Historically,!women!who!reported!vulvar!pain!or!pain!with!intercourse!were!often!told!
that!the!pain!was!“all!in!their!head.”!!Being!told!to!“just!relax,”!“have!a!glass!of!wine,”!or!
to!see!a!therapist!can!be!very!dismaying!for!women!with!vulvodynia,!who!may!have!
suffered!for!months!or!years!from!their!condition,!often!without!a!diagnosis.!
Stress!is!an!ambiguous!term!that!is!used!widely!in!our!culture!and!is!often!assumed!to!
be!something!we!have!control!over!–!but!often!we!don’t.!!The!brain!constantly!tries!to!
process!everyday!physical,!environmental,!social!and!psychological!stressors!through!a!
process!of!communicating!cells!and!hormones!known!as!allostasis!(Sterling!&!Ayer,!
1988).!!Allostasis!is!the!process!by!which!the!body!meets!stressors!and!then!returns!the!
body!to!a!steady!state!of!balance!
Allostasis!is!the!body’s!way!of!selfBregulating!
known!as!homeostasis.!!
to!stay!balanced,!promote!healing!and!be!
When!the!body!is!no!longer!able!to!
resilient.!
return!to!homeostasis,!resilience!is!lost.!!
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Alisa Pascale is a women’s health nurse practitioner at Vincent Gynecology, Massachusetts General Hospital and
has been caring for women with vulvar pain and vulvo-vaginal disorders since 2001. She is also a Doctorate of
Nursing Practice Candidate at the MGH Institute of Health Professions.
Alisa gratefully acknowledges the support and expertise of MGH Institute of Health Professions Adjunct Professor
and Faculty Advisor Margaret Baim in the research and development of this fact sheet. Ms. Baim is a nurse
practitioner and internationally recognized clinical educator who directs the Relaxation Response Resiliency
Program at the Benson-Henry Institute for Mind-Body Medicine at MGH.
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Vulvodynia,!Vestibulodynia,!Pain!and!your!Brain!
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Pascale,!January!2014!
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Researchers!use!a!term!called!allostatic!load!to!describe!“the!ways!in!which!the!body!
fails!to!cope!with!psychological,!environmental!and!physical!challenges”!(McEwen!&!
Seeman,!2009).!!Social!context!
and!fear,!including!social!
For!women!with!vulovodynia,!social!fears!
fears,!are!a!significant!source!
may!include!those!about!their!selfBimage!as!
of!allostatic!load!(Ganzel,!
women,!their!body!image,!sexuality!and!
Morris!&!Wethingon,!2010).!!
relationships!(Basson,!2012).!
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• It!is!now!understood!that!repeated!exposure!to!stress!either!through!early!or!chronic!
exposure!causes!wear!and!tear!on!the!body’s!ability!to!sustain!balance!and!resilience.!!
This!occurs!through!several!pathways,!most!notably!through!a!remodeling!of!the!brain!
to!be!less!efficient!at!restoring!homeostasis.!!These!changes!can!alter!levels!of!stress!
hormones!and!other!neurotransmitters,!which!in!turn!affect!our!thoughts,!actions!and!
emotions!(Arnsten,!2009)!and!can!also!lead!to!changes!in!the!immune!system,!gut,!and!
skin!(Chrousos,!1997!&!2000;!Basson,!2012).!!Subsequently,!a!negative!feedback!loop!
can!develop!that!alters!the!body’s!cellular!communication!and!hormones!towards!
greater!sensitivity!to!and!signaling!of!pain.!!A!2008!study!by!Schweinhardt!et!al.!showed!
that!women!with!chronic!vulvar!pain!do!have!differences!in!their!brain!anatomy!(as!
compared!to!aged!matched!controls),!lending!further!support!to!the!idea!that!the!brain!
is!an!important!modulator!of!pain!in!women!with!vulvodynia.!
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2) You'are'not'alone.'''
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• An!estimated!7B8%!of!women!in!the!United!States!describe!vulvodyniaBlike!symptoms.!
As!many!as!16%!of!women!may!experience!symptoms!suggestive!of!vulvodynia!in!their!
lifetime!(Harlow!&!Stewart,!2003;!Reed!&!Harlow!at!al.,!2012).!!Women!with!vulvodynia!
report!feeling!isolated!and!
invalidated!(Nguyen!et!al,!
What'can'you'do?'
2012).!!
Seek!support!from!friends,!family!and/or!other!
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women!with!vulvodynia.!Some!online!resources!
• Women!with!vulvar!pain!
include:!
experience!significant!
www.nva.org!
reductions!in!quality!of!life!
www.vBmatters.org!
(Sargeant!&!O’Callaghan,!
www.issvd.org!
2007).!!In!one!study,!42%!of!
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women!with!vulvodynia!felt!
out!of!control!of!their!lives;!60%!
reported!feeling!out!of!control!of!their!bodies!(Arnold!et!al.,!2006).!!
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Vulvodynia,!Vestibulodynia,!Pain!and!your!Brain!
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3) The'terms'vulvodynia'and'vestibulodynia'describe'symptoms'but'are'not'
necessarily'one'disorder.'!!
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The!pain!or!discomfort!of!vulvodynia!can!be!localized!or!diffuse!and!provoked!or!
unprovoked!(by!things!such!as!touch,!tampons,!clothing!or!sexual!intercourse).!!These!
symptoms!probably!result!from!more!than!one!cause,!or!often!a!combination!of!factors!
that!may!include!yeast!infections,!local!peripheral!inflammation,!pelvic!floor!muscle!pain!
or!tightness,!central!nervous!system!pain!regulatory!pathways!and!even!genetic!factors!
–!all!of!which!may!differ!from!woman!to!woman!and!activate!allostasis!that!compromise!
resilience!!(BohmBStarke!et!al.,!2001;!Witkin,!Gerber!&!Ledger,!2002;!Gerber!at!al.,!2003;!
Foster,!Sazenski!&!Stodgell,!2004;!Granot!et!al.,!2004;!Haefner!et!al.,!2005;!Zolnoun!et!
al.,!2006,!Andrews,!2011;!Leclair!et!al.,!2011;!Reed!&!Payne!et!al.,!2012).!!!
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In!some!cases,!genetics!may!have!something!to!do!with!your!pain.!!Women!with!
vestibulodynia!may!have!a!genetic!variation!that!makes!them!more!prone!to!
inflammation,!which!may!be!triggered!in!some!cases!by!yeast!infections!(Foster,!
Sazenski!&!Stodgell,!2004;!LevBSage!et!al.,!2009).!!!!
Women!with!vestibulodynia!have!been!shown!to!experience!increased!sensitivity!to!
touch!in!other!parts!of!the!body!including!the!forearm!and!foot!(Basson,!2012).!This!is!
considered!evidence!of!something!
called!Central!Sensitization.!!
What'can'you'do?'
Central!Sensitization!is!a!term!
Although!you!can’t!do!much!to!change!your!
used!to!describe!abnormal!
genetics,!you!can!find!a!healthcare!provider!
signaling!between!the!
who!has!experience!diagnosing!and!treating!
periphery!(i.e.!the!vulva)!and!
vulvodynia.!!She!or!he!can!help!you!sort!out!all!
spinal!cord,!and!between!the!
the!possible!causes!and!offer!treatment!options!
spinal!cord!and!brain,!which!
depending!on!your!particular!situation.!
may!play!an!important!role!in!
causing!and!continuing!chronic!
pain!(Basson).!!Future!research!on!vulvodynia!has!focused!on!and!will!benefit!from!
collaborate!efforts!with!the!broader!pain!research!community!(Eunice!Kennedy!Shriver!
NICHHD,!2012;!Institute!of!Medicine,!2011;!Bachmann!et!al.!2006).!!
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4) The'pain'of'vulvodynia'is'not'all'in'your'head,'but'the'effect'that'anxiety'and'
mood'disorders'have'on'the'brain'probably'play'a'role'in'the'development'of'
vulvodynia'in'some'women.!Conversely,'vulvodynia'can'cause'recurrent'or'
new'anxiety'and'mood'disorders.'
• Women!with!mood!or!anxiety!disorders!are!4!times!more!likely!than!women!without!to!
develop!vulvodynia!(Khandker!et!al.,!2011).!!
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Vulvodynia,!Vestibulodynia,!Pain!and!your!Brain!
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• Vulvodynia!can!increase!your!risk!of!new!or!recurrent!anxiety!and!depression!(Khandker,!
et!al.).!!
What'can'you'do?''
• Depression!is!known!
If!you!have!suffered!from!depression!and/or!anxiety!
to!alter!pain!
in!the!past,!or!currently!feel!very!anxious!or!
processing!in!other!
depressed!now!as!you!try!to!cope!with!your!
conditions!such!as!
condition,!be!sure!to!talk!with!your!health!care!
fibromyalgia.!
provider!about!it.!!In!addition,!you!will!likely!benefit!
(Basson,!2012).!
from!supportive!psychotherapy!or!cognitive!
behavioral!therapy.!
• People!with!
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depression!and!anxiety!
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tend!to!perceive!pain!differently!and!tolerate!pain!less,!and!are!also!less!likely!to!be!
able!to!be!distracted!from!their!pain!(MeltzerBBrody!&!Lesserman,!2011).!!
• Pain!contributes!to!chronic!stress!that!leads!to!allostatic!load!and!associated!
psychopathologies!such!as!anxiety!and!depression.!!(Juster,!Bizik,!et!al.,!2011;!Dominick,!
Blyth,!et!al.,!2012).!
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5)''It'may'not'be'a'coincidence'if'you'have'other'chronic'conditions.''
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• Women!with!vulvodynia!and!vestibulodynia!are!significantly!more!likely!than!women!
without!vulvar!pain!to!have!other!chronic!pain!conditions!including!interstitial!cystitis,!
fibromyalgia,!chronic!fatigue!syndrome,!headache,!as!well!as!irritable!bowel!and!chronic!
fatigue!syndrome!(Reed!&!Harlow!et!al.,!2012;!Andrews,!2011).!!!Pain!increases!stress!
that!tips!the!body’s!immune!
balance!toward!
What'can'you'do?'
inflammatory!processes!
Interventions!discussed!later!in!this!Fact!Sheet!
and!threatens!the!body’s!
have!in!some!cases!been!shown!to!be!helpful!at!
ability!to!self!regulate!
reducing!symptoms!for!patients!with!a!variety!of!
itself!to!stay!healthy!and!
conditions,!such!as!fibromyalgia.!!Efforts!to!reduce!
balanced.!(Dominick,!
allostatic!load!may!improve!symptoms!from!more!
Blyth,!et!al.,!2012).!
than!one!condition.!!!
Unfortunately,!the!more!
conditions!you!have,!the!
harder!it!may!be!to!completely!recover!from!vulvar!pain!(Heddini!et!al.,!2012),!but!read!
on!to!learn!about!skills!that!may!help.!!
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Having!multiple!conditions!as!described!above!is!seen!as!additional!evidence!for!central!
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sensitization,!whereby!genetic,!environmental!and!psychosocial!factors!may!cause!abnormal!
changes!in!the!processing!of!pain!at!the!periphery,!spinal!cord!and!brain!(Basson,!2012).!
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6) It'is'possible'that'stressful'or'traumatic'life'events'in'your'past'may'have'
“primed”'your'brain'in'such'a'way'that'contributed'to'the'onset'of'(or'may'
play'a'role'in)'your'ongoing'pain'(Plante!&!Kamm,!2008).'
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• Most!studies!show!that!women!with!vulvodynia!have!not!experienced!higher!rates!of!
sexual!abuse.!However,!several!studies!have!shown!that!women!with!vulvodynia!do!
report!more!adverse!life!events,!such!as!adverse!previous!relationships,!parental!
divorce!or!adverse!childbirth!experiences!than!women!without!vulvar!pain!(Plante!&!
Kamm).!!!
What'can'you'do?'
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Speak!with!your!health!care!provider!and!therapist!
• In!one!population!based!
if!you!have!concerns!about!how!earlier!life!events!
study,!women!with!
may!have!influenced!you!today.!
vulvodynia!were!2.6!times!
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more!likely!to!report!lack!
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of!family!support!(comfort,!encouragement!and!love).!!Women!who!developed!
vulvodynia!as!adults!were!significantly!more!likely!to!report!childhood!abuse!(physical!
or!sexual)!than!aged!matched!controls.!(Harlow!&!Stewart,!2004).!!!
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7) How'you'cope'with'stress,'worry'and'fear'probably'impacts'how'your'body'
experiences'pain'and'how'it'heals.''Let’s!face!it!–!we!all!have!different!temperaments!
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and!personalities.!Some!of!us!tend!to!see!the!glass!half!full,!others!half!empty.!!Our!genes!
shape!some!of!these!traits!while!others!are!probably!influenced!by!our!environment!and!life!
experiences.!'
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Women!with!localized!provoked!vulvodynia!reported!more!signs!of!stress!and!showed!
statistically!significant!evidence!of!systemic!stress!(changes!in!levels!of!a!stress!hormone!
called!cortisol!upon!awakening)!as!compared!to!women!without!pain!(Ehrstom!et!al.,!
2009).'
Women!with!primary!
vestibulodynia!showed!
higher!levels!of!
somatization,!anxiety!
and!distress!as!compared!
to!women!with!
secondary!vestibulodynia!
(Zolnoun!et!al.,!2008).!!
What'can'you'do?'
The!good!news!is!that!a!large!body!of!research!
suggests!that!we!can!learn!new!coping!skills,!and!
when!we!do,!we!reduce!the!effects!of!allostatic!load!
–!or!stress!–!on!the!brain.!Over!time,!these!new!
habits!may!reduce!stress!hormones,!inflammation,!
improve!pain!perception!and!help!with!healing.!!
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In!chronic!pain!patients,!a!tendency!to!focus!on!pain!(called!attentional!bias)!increases!
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pain,!disability!and!distractibility!(Van!Ryckeghem!et!al.,!2013).!!Focusing!on!pain!is!also!
!
thought!to!trigger!the!fear!response,!which!can!increase!stress!and!attention!to!pain.'
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Vulvodynia,!Vestibulodynia,!Pain!and!your!Brain!
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Women!with!higher!levels!of!selfBefficacy!reported!
less!pain!intensity!after!treatment!with!both!
topical!treatments!and!cognitive!behavioral!
therapy!than!women!with!higher!levels!of!baseline!
fear!of!pain!and!catastrophizing!(Desrochers!et!al,!
2010).!As!maladaptive!coping!increases!risk!for!
allostatic!load,!adaptive!coping!is!protective.!
(Juster,!Bizik,!et!al.,!2011).!
As!mentioned!in!the!introduction,!fear,!including!
social!fear,!is!a!significant!trigger!of!the!stress!
response!(Rodrigues,!LeDoux!&!Sapolsky,!2009;!
Ganzel,!Morris!&!Wethington,!2010).!!
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Thoughts!come!from!the!underlying!beliefs!of!emotions!and!those!that!trigger!stress!
such!as!catastrophizing!are!associated!with!depression!and!anxiety,!two!significant!
predictors!of!vestibular!pain!in!postmenopausal!women!with!painful!intercourse!–!while!
hormone!levels!were!not!(Kao!et!al.,!2012).!!!
After!vestibulectomy!(surgical!removal!of!the!painful!vestibulodynia!tissue)!women!with!
higher!levels!of!stress!and!distress!tend!to!have!more!pain!with!intercourse!than!women!
with!lower!levels!of!stress!and!distress/anxiety!(Eanes!et!al.,!2011).!!
Research!has!shown!that!women!with!higher!positive!affect!and!lower!negative!affect!
report!lower!levels!of!pain!(Zautra,!Johnson!&!Davis,!2005).!
In!older!adults!with!arthritis,!greater!“dispositional!optimism”!(a!positive!personality!
trait)!was!associated!with!lower!levels!of!pain!catastrophizing!(Goodin!et!al.,!2013).!!
What'Can'You'Do?'
Catastrophizing!refers!to!predicting!negative!outcomes!and!assuming!that!the!
negative!outcome!will!be!catastrophic.!!To!overcome!this!tendency,!focus!your!
thoughts!on!the!experience!of!the!present!moment!in!what!is!known!as!mindful!
awareness.!Try!to!catch!yourself!having!these!kinds!of!negative!thoughts,!and!
then!try!to!replace!the!negative!thoughts!by!considering!other!neutral!or!positive!
outcomes!instead!(Boyes,!2013). In!fact,!positive!expectation!applied!to!your!
ability!to!cope!and!to!your!body’s!ability!to!heal,!triggers!the!brain!to!release!pain!
and!stressSbuffering!chemicals!(McEwen!and!Kalia,!2010).!
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SelfSefficacy!refers!to!one’s!
belief!in!one’s!capabilities.!
People!with!a!strong!sense!of!
selfSefficacy!view!challenges!as!
opportunities,!have!a!deep!
interest!in!and!a!strong!sense!of!
commitment!to!their!activities!
and!recover!quickly!from!
setbacks!and!disappointments!
(Cherry,!2013).!!
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8) Women'with'vulvodynia'experience'significant'sexual'side'effects'including'
pain'with'sex'and'loss'of'sex'drive/desire/libido.'
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41%!of!women!indicated!that!vulvodynia!
had!a!severe!effect!on!their!sexual!lives!
What'can'you'do?'
(Arnold!et!al.,!2006).!
Talk!to!your!health!care!provider!and!consider!
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finding!a!therapist!who!is!comfortable!
discussing!sexual!issues.!
• Chronic!vulvar!pain!has!a!negative!
To!find!a!sex!therapist!near!you:!
impact!on!the!couple!relationship!and!
http://www.aasect.org!
causes!significant!distress!related!to!
!
sexual!activities!(Sargeant!&!
O’Callaghan,!2007).!!
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• Social!factors!and!experiences!–!not!only!the!pain!itself!B!also!influence!women’s!
experiences!of!sexual!pain!(Farrell!&!Cacchioni,!2012).!
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9) In'the'same'way'that'life'stressors,'stress,'anxiety'and'depression'may'
“prime”'the'brain'to'be'more'susceptible'to'inflammation'and'pain,'there'are'
also'helpful'skills'that'you'can'learn'and'cultivate'that'help'to'reverse'these'
stressors.''Such!skills!have!been!shown!to!decrease!stress,!improve!coping,!reduce!pain!
and!increase!wellBbeing,!which!all!together!work!to!reduce!allostatic!load!and!support!the!
body!back!to!resilience!and!normal!physiologic!balance.!'
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• Resilience!(allostatic!load!is!a!loss!of!resilience)!is!a!term!used!to!describe!a!healthy!
body,!one!that!is!able!to!bounce!back!from!stress!and!illness.!!A!number!of!attitude!and!
behaviors!have!been!shown!to!strengthen!the!body’s!ability!to!sustain!or!restore!
resilience!and!as!such!buffer!against!allostatic!load.!!These!very!useful!attitudes!and!
behaviors!includes:!!optimism,!humor,!cognitive!flexibility,!acceptance,!religion/!
spirituality,!altruism!(helping!others),!social!support,!role!models,!moderate!physical!
activity/!exercise,!ability!to!
recover!from!negative!
What'can'you'do?'
events,!and!positive!
Write!down!three!things!that!went!well!for!you!every!
emotions!(Southwick,!
day!for!a!week.!Research!shows!that!by!doing!this!
Vythilingam!&!
regularly!you!can!buffer!stress!and!improve!your!wellS
Charney,!2005;!Feder,!
being!(Seligman,!2002)!
Nestler!&!Charney,!
!
2009).!!
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• Positive!emotions!can!undo!negative!emotions,!improve!resilience!and!build!personal!
resources,!leading!to!greater!wellbeing!and!more!optimal!functioning!over!
time!!(Fredrickson,!2004).!!These!skills!can!be!learned!and!do!make!a!difference!in!
people’s!lives!(Cohn!&!Fredrickson,!2010;!Seligman,!Rashid!&!Parks,!2006).!One!simple!
method!is!to!increase!your!
experience!of!appreciation;!
What#can#you#do?#
one!of!the!most!studied!
Before!you!go!to!bed!at!night!jot!down!several!
positive!emotions.!!
experiences!from!the!day!that!lead!you!to!
appreciate!yourself,!others,!or!life!in!general.!Next,!
• Yoga!(taught!within!the!
in!your!imagination,!relive!each!of!these!experiences!
framework!of!meditation)!can!
until!you!feel!appreciation.!!Amazingly,!by!focusing!
improve!mood!and!reduce!
your!mind!in!this!way,!it!will!only!take!about!30!
anxiety!to!a!greater!extent!
seconds!to!feel!each!appreciation.!(Damasio,!
than!walking!(Streeter!et!al.,!
Grabowski,!et!al.!2000).!
2010).!!
!
!
•
!
•
!
!
!!
Listening!to!music!has!also!been!shown!to!decrease!pain!in!men!and!women!with!a!
variety!of!pain!disorders!(Guetin!et!al.,!2011).!When!listening!is!such!a!compelling!focus!
that!it!inhibits!the!ordinary!consciousness!of!day!to!day!thinking,!it!becomes!a!form!of!
meditation.!!In!this!way,!music!allows!thoughts,!images,!and!feelings!to!come!to!mind,!in!
a!momentBtoBmoment!experience!of!oneself.!!
Mindfulness!is!another!form!of!meditation!that!refers!to!a!way!to!improve!conscious!
attention!and!awareness!and!has!been!shown!to!improve!wellbeing,!decrease!pain!
catastrophizing!and!increase!positive!emotional!states!(Brown!&!Ryan,!2003;!Basson,!
2012).!
• In!just!a!few!weeks,!novice!meditators!have!been!shown!to!develop!brain!changes!
associated!with!memory,!learning,!emotion!regulation,!selfBawareness,!cognitive!
flexibility!in!support!of!perspective!taking!and!less!stress.!The!brain!scans!of!long!term!
meditators!evidence!even!more!of!these!desirable!changes!!(Lazar,!et!al.!2005;!Holzel,!
Carmody,!J.,!et!al.!2009;!
Holzel,,!Carmody,!et!
What'can'you'do?'
al.!2011).!!Several!
Increase!your!positive!emotions!when!you!
studies!have!also!
exercise,!help!others,!engage!in!enjoyable!
shown!meditation!
social!interaction!or!a!pleasant!activity,!
positively!impacts!the!
play,!laugh,!learn!something!useful,!and!
immune!cells!at!a!
practice!mindfulness!or!a!meaningful!
genetic!level!(Jacobs!
spiritual!activity.!
et!al.,!2011).!
!(Catalino!&!Fredrickson,!2011).!!!
!
!
!
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Vulvodynia,!Vestibulodynia,!Pain!and!your!Brain!
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Pascale,!January!2014!
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9!
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10) There'are'growing'numbers'of'resources'and'mind'body'approaches'that'
show'promise'in'decreasing'pain'and'improving'wellbeing.'
•
•
!
•
Mindfulness!–Based!Stress!Reduction!(MBSR)!is!a!mindfulnessBbased!program!that!has!
been!shown!to!reduce!stress!and!the!associated!cortisol!and!immune!responses.!It!has!
been!tested!with!a!number!of!medical!conditions!including!pain!cancer,!depression!and!
anxiety!(Grossman!et!al.,!2004;!Basson,!2012).!!
•
Additional!benefit!will!likely!be!achieved!from!any!method!that!engages!mind!body!
pathways!that!lead!to!relaxation!or!a!positive!shift!in!mood.!These!include,!but!are!no!
means!limited!to:!acupuncture,!Reiki,!Healing!Touch,!and!massage.!!
!
!
!!
!
Vulvodynia!experts!advocate!an!interdisciplinary!approach!to!treatment,!which!may!
include!physical!therapists,!sex!therapists,!social!workers!and/or!psychologists!trained!in!
cognitive!behavioral!therapy!(CBT)!or!mindfulness!–based!cognitive!therapy!(MBCT).!
!!
The!Benson!Henry!Institute!for!Mind!Body!Medicine!at!MGH!is!a!leader!in!the!field!of!
mindB!bodyBresilience!medicine.!They!conduct!research!on!mind/body!interactions!and!
on!interventions!that!treat!a!variety!of!conditions!that!include!autoB!immune!disorders,!
chronic!pain!syndromes,!heart!disease,!infertility,!and!mood!disorders.!!They!offer!
individual!counseling!that!includes!meditation!skill!building,!cognitive!behavioral!
therapy!as!well!as!group!programs!that!have!been!shown!to!increase!resilience!and!
improve!symptoms!and!their!underlying!imbalances.!!!!
!
!
!
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!
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!
!
!
!
In!addition!to!many!books!&!tapes!available!about!
meditation/mindfulness,!courses!specific!to!health!are!offered!at:!
!
The!BensonSHenry!Institute!for!Mind!Body!Medicine!
http://www.massgeneral.org/bhi/about/!
!
To!find!an!MBSR!program!worldwide:!
http://w3.umassmed.edu/MBSR/public/searchmember.aspx!
!
To!find!a!yoga!instructor!near!you:!
http://www.yogajournal.com/directory/!
!
!
!
Keep'learning'as'much'as'you'can'about'Vulvodynia.'
!
Knowledge'is'powerful!'
!
'
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Vulvodynia,!Vestibulodynia,!Pain!and!your!Brain!
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Pascale,!January!2014!
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