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Hope K. Haefner - One of the best experts on this subject based on the ideXlab platform.

  • Generalized vulvar Dysesthesia vs. vestibulodynia. Are they distinct diagnoses
    The Journal of reproductive medicine, 2003
    Co-Authors: Barbara D. Reed, Daniel W. Gorenflo, Hope K. Haefner
    Abstract:

    OBJECTIVE: To evaluate prospectively whether generalized vulvar Dysesthesia and vestibulodynia possess unique characteristics that support the theory of differing etiologies, STUDY DESIGN: Women with vulvar Dysesthesia for a minimum of 3 months were enrolled at the University of Michigan in 2 clinics specializing in vulvar disorders. Informed consent was obtained. Participants completed a 27-page questionnaire and had a physical examination. Differentiation of generalized vulvar Dysesthesia and vestibulodynia was based on tenderness to light pressure isolated to the introitus vs. pain beyond the introitus, respectively. We compared women with the 2 diagnoses to each other on demographic characteristics, exposures, pain characteristics and physical findings using t test, Mann-Whitney U and X 2 analysis. RESULTS: Between January 26, 2001, and August 28, 2002, we enrolled 39 women, aged 18-60 years, with tenderness localized to the vestibule (vestibulodynia) and 17 with generalized vulvar Dysesthesia. Women in each diagnostic group were similar in demographic and exposure characteristics. The pain characteristics were similar between the 2 groups except that recent pain was rated as worse by those with generalized vulvar Dysesthesia. Activities that aggravated or relieved the pain were similar. However, women with generalized vulvar Dysesthesia were more likely to state that their pain was aggravated by sitting and by washing the area. Similar results were found when using continuous pain rather than vulvar pain location as the outcome variable, CONCLUSION: The characteristics of women with generalized vulvar Dysesthesia are similar to those with localized pain, supporting the theory that the 2 disorders may exhibit 2 presentations on a continuum of severity seen in vulvar Dysesthesia rather than 2 distinct entities.

  • Sexual activities and attitudes of women with vulvar Dysesthesia.
    Obstetrics and gynecology, 2003
    Co-Authors: Barbara D. Reed, Daniel W. Gorenflo, Arnold P. Advincula, Karen R Fonde, Hope K. Haefner
    Abstract:

    Abstract Objective To assess the relationship between sexual activities and attitudes of women with and without vulvar Dysesthesia. Methods Women with vulvar Dysesthesia, 18–60 years old, and ethnically matched women without this disorder were enrolled in this cross-sectional study, completed a 27-page questionnaire, and had a physical examination. We compared sexual activities and attitudes between patients and controls using univariate and multivariable analyses. Results Between January 21, 2001, and December 12, 2002, we enrolled 63 women with vulvar Dysesthesia and 62 controls who reported having a current sexual partner. Women with vulvar Dysesthesia were less likely than controls to have had, during the previous month, intercourse (66.7% versus 83.9%, P = .03) and orgasms (57.6% versus 78.7%, P = .02), although the association with intercourse was no longer statistically significant after controlling for age, education, and smoking status ( P = .07). Of those having had intercourse in the past month, the frequency of this activity was less among patients (3.0 ± 2.7 versus 6.2 ± 4.5 episodes, P P Conclusion Women with vulvar Dysesthesia are similar to those without in many sexual activities but are less likely to have had an orgasm in the past month or to have had intercourse at the same frequency as controls. Although some attitudes were similar, sexual interest and self-concept were decreased among those with this disorder.

  • Depressive symptoms among women with vulvar Dysesthesia.
    American journal of obstetrics and gynecology, 2003
    Co-Authors: James E. Aikens, Barbara D. Reed, Daniel W. Gorenflo, Hope K. Haefner
    Abstract:

    Abstract OBJECTIVE: The purpose of this study was to determine whether vulvar Dysesthesia is associated with elevated depressive symptoms. STUDY DESIGN: This was a cross-sectional case-control study of women who underwent treatment of vulvar Dysesthesia (n=32) or who were seen for a routine gynecologic examination (n=32). Subjects completed measures of depressive symptoms and pain and a sexual and medical history. Multivariate and univariate analyses were conducted. RESULTS: Analyses that were adjusted for age, education, and medical conditions indicated that vulvar Dysesthesia was associated positively with depressive symptoms ( P =.002). However, this was attributable to the somatic ( P =.002) rather than cognitive-affective symptoms ( P =.16) of depression, partially related to the endorsement of sexual disinterest, and mediated by pain reports. CONCLUSION: Vulvar Dysesthesia is associated with elevated depressive symptom severity, although not to the extent that indicates probable depressive disorder. In this condition, depressive symptoms are likely to be a measurement artifact, rather than a depressive process. Certain depressive symptoms (eg, sexual disinterest) directly inflate depression estimates in this patient group.

  • Vulvar Dysesthesia (vulvodynia). A follow-up study.
    The Journal of reproductive medicine, 2003
    Co-Authors: Barbara D. Reed, Hope K. Haefner, Lauren Cantor
    Abstract:

    OBJECTIVE To assess long-term outcome in women treated for vulvar Dysesthesia (vulvodynia). STUDY DESIGN Cross-sectional survey via mailed questionnaires of women with vulvar Dysesthesia treated at the University of Michigan. Questionnaires addressed symptom characteristics and their predictors, pregnancy response and treatments used. Analysis included t tests, nonparametric tests and multivariate analyses to assess associations between the degree of improvement (in the amount of pain experienced) since diagnosis and potential predictors of that outcome. RESULTS Of 234 questionnaires mailed, 104 were completed. Based on a 7-point pain scale (0-6, with 6 indicating excruciating pain), the level of pain at the time of the survey (1.6 +/- 1.3) was significantly lower than that at the time of diagnosis (4.5 +/- 1.5) (P 50% improvement in their pain since diagnosis, and the pain had worsened in 1.9%. Greater improvement was noted with higher pain levels at baseline and with a shorter time since onset. The majority of women who had been pregnant since developing vulvar pain reported improvement (30%) or no change (40%) in symptoms during and after pregnancy. Treatments (nonrandom) rated as most effective included antidepressants (used for pain control) and anticonvulsant medications, biofeedback and counseling. CONCLUSION Most women with vulvar Dysesthesia reported markedly less pain at follow-up, although few reported a "cure." Pregnancy was not associated with worsening of vulvar symptoms for most women. Controlled clinical trials will be needed to elucidate treatments that are most effective.

  • victimization in patients with vulvar Dysesthesia vestibulodynia is there an increased prevalence
    Journal of Reproductive Medicine, 2002
    Co-Authors: Vanessa K. Dalton, Barbara D. Reed, Hope K. Haefner, S. Senapati, Ann Cook
    Abstract:

    OBJECTIVE: To examine the prevalence of physical or sexual violence victimization among women referred to a specialty clinic for management of vulvar Dysesthesia/vestibulodynia as compared to a healthy gynecology clinic population. STUDY DESIGN: The subjects in this case-control study were women who had completed routine questionnaires prior to presentation to the University of Michigan Center for Vulvar Diseases. Study subjects were all given a diagnosis of vulvar Dysesthesia/vestibulodynia. Women without complaints of vulvar pain presenting to a gynecology clinic were enrolled as controls. Information was obtained from the control subjects using a questionnaire similar to the history forms completed by the study group. RESULTS: Comparisons were made between 242 patients with vulvar Dysesthesia/vestibulodynia presenting to a specialty clinic and 113 controls. Cases were more likely to be Caucasian, to be married and to have a higher household income than controls but reported less drug or alcohol abuse and a lower frequency of sexual intercourse. After controlling for possible confounders, no relationship between sexual assault and the presence of vulvar Dysesthesia/vestibulitis was found. CONCLUSION: The prevalence of victimization was not higher in patients with vulvar Dysesthesia/vestibulodynia as compared to the control population after controlling for potential confounding variables. Language: en

Kazuo Matsubara - One of the best experts on this subject based on the ideXlab platform.

Yuna Tei - One of the best experts on this subject based on the ideXlab platform.

Barbara D. Reed - One of the best experts on this subject based on the ideXlab platform.

  • Generalized vulvar Dysesthesia vs. vestibulodynia. Are they distinct diagnoses
    The Journal of reproductive medicine, 2003
    Co-Authors: Barbara D. Reed, Daniel W. Gorenflo, Hope K. Haefner
    Abstract:

    OBJECTIVE: To evaluate prospectively whether generalized vulvar Dysesthesia and vestibulodynia possess unique characteristics that support the theory of differing etiologies, STUDY DESIGN: Women with vulvar Dysesthesia for a minimum of 3 months were enrolled at the University of Michigan in 2 clinics specializing in vulvar disorders. Informed consent was obtained. Participants completed a 27-page questionnaire and had a physical examination. Differentiation of generalized vulvar Dysesthesia and vestibulodynia was based on tenderness to light pressure isolated to the introitus vs. pain beyond the introitus, respectively. We compared women with the 2 diagnoses to each other on demographic characteristics, exposures, pain characteristics and physical findings using t test, Mann-Whitney U and X 2 analysis. RESULTS: Between January 26, 2001, and August 28, 2002, we enrolled 39 women, aged 18-60 years, with tenderness localized to the vestibule (vestibulodynia) and 17 with generalized vulvar Dysesthesia. Women in each diagnostic group were similar in demographic and exposure characteristics. The pain characteristics were similar between the 2 groups except that recent pain was rated as worse by those with generalized vulvar Dysesthesia. Activities that aggravated or relieved the pain were similar. However, women with generalized vulvar Dysesthesia were more likely to state that their pain was aggravated by sitting and by washing the area. Similar results were found when using continuous pain rather than vulvar pain location as the outcome variable, CONCLUSION: The characteristics of women with generalized vulvar Dysesthesia are similar to those with localized pain, supporting the theory that the 2 disorders may exhibit 2 presentations on a continuum of severity seen in vulvar Dysesthesia rather than 2 distinct entities.

  • Sexual activities and attitudes of women with vulvar Dysesthesia.
    Obstetrics and gynecology, 2003
    Co-Authors: Barbara D. Reed, Daniel W. Gorenflo, Arnold P. Advincula, Karen R Fonde, Hope K. Haefner
    Abstract:

    Abstract Objective To assess the relationship between sexual activities and attitudes of women with and without vulvar Dysesthesia. Methods Women with vulvar Dysesthesia, 18–60 years old, and ethnically matched women without this disorder were enrolled in this cross-sectional study, completed a 27-page questionnaire, and had a physical examination. We compared sexual activities and attitudes between patients and controls using univariate and multivariable analyses. Results Between January 21, 2001, and December 12, 2002, we enrolled 63 women with vulvar Dysesthesia and 62 controls who reported having a current sexual partner. Women with vulvar Dysesthesia were less likely than controls to have had, during the previous month, intercourse (66.7% versus 83.9%, P = .03) and orgasms (57.6% versus 78.7%, P = .02), although the association with intercourse was no longer statistically significant after controlling for age, education, and smoking status ( P = .07). Of those having had intercourse in the past month, the frequency of this activity was less among patients (3.0 ± 2.7 versus 6.2 ± 4.5 episodes, P P Conclusion Women with vulvar Dysesthesia are similar to those without in many sexual activities but are less likely to have had an orgasm in the past month or to have had intercourse at the same frequency as controls. Although some attitudes were similar, sexual interest and self-concept were decreased among those with this disorder.

  • Depressive symptoms among women with vulvar Dysesthesia.
    American journal of obstetrics and gynecology, 2003
    Co-Authors: James E. Aikens, Barbara D. Reed, Daniel W. Gorenflo, Hope K. Haefner
    Abstract:

    Abstract OBJECTIVE: The purpose of this study was to determine whether vulvar Dysesthesia is associated with elevated depressive symptoms. STUDY DESIGN: This was a cross-sectional case-control study of women who underwent treatment of vulvar Dysesthesia (n=32) or who were seen for a routine gynecologic examination (n=32). Subjects completed measures of depressive symptoms and pain and a sexual and medical history. Multivariate and univariate analyses were conducted. RESULTS: Analyses that were adjusted for age, education, and medical conditions indicated that vulvar Dysesthesia was associated positively with depressive symptoms ( P =.002). However, this was attributable to the somatic ( P =.002) rather than cognitive-affective symptoms ( P =.16) of depression, partially related to the endorsement of sexual disinterest, and mediated by pain reports. CONCLUSION: Vulvar Dysesthesia is associated with elevated depressive symptom severity, although not to the extent that indicates probable depressive disorder. In this condition, depressive symptoms are likely to be a measurement artifact, rather than a depressive process. Certain depressive symptoms (eg, sexual disinterest) directly inflate depression estimates in this patient group.

  • Vulvar Dysesthesia (vulvodynia). A follow-up study.
    The Journal of reproductive medicine, 2003
    Co-Authors: Barbara D. Reed, Hope K. Haefner, Lauren Cantor
    Abstract:

    OBJECTIVE To assess long-term outcome in women treated for vulvar Dysesthesia (vulvodynia). STUDY DESIGN Cross-sectional survey via mailed questionnaires of women with vulvar Dysesthesia treated at the University of Michigan. Questionnaires addressed symptom characteristics and their predictors, pregnancy response and treatments used. Analysis included t tests, nonparametric tests and multivariate analyses to assess associations between the degree of improvement (in the amount of pain experienced) since diagnosis and potential predictors of that outcome. RESULTS Of 234 questionnaires mailed, 104 were completed. Based on a 7-point pain scale (0-6, with 6 indicating excruciating pain), the level of pain at the time of the survey (1.6 +/- 1.3) was significantly lower than that at the time of diagnosis (4.5 +/- 1.5) (P 50% improvement in their pain since diagnosis, and the pain had worsened in 1.9%. Greater improvement was noted with higher pain levels at baseline and with a shorter time since onset. The majority of women who had been pregnant since developing vulvar pain reported improvement (30%) or no change (40%) in symptoms during and after pregnancy. Treatments (nonrandom) rated as most effective included antidepressants (used for pain control) and anticonvulsant medications, biofeedback and counseling. CONCLUSION Most women with vulvar Dysesthesia reported markedly less pain at follow-up, although few reported a "cure." Pregnancy was not associated with worsening of vulvar symptoms for most women. Controlled clinical trials will be needed to elucidate treatments that are most effective.

  • victimization in patients with vulvar Dysesthesia vestibulodynia is there an increased prevalence
    Journal of Reproductive Medicine, 2002
    Co-Authors: Vanessa K. Dalton, Barbara D. Reed, Hope K. Haefner, S. Senapati, Ann Cook
    Abstract:

    OBJECTIVE: To examine the prevalence of physical or sexual violence victimization among women referred to a specialty clinic for management of vulvar Dysesthesia/vestibulodynia as compared to a healthy gynecology clinic population. STUDY DESIGN: The subjects in this case-control study were women who had completed routine questionnaires prior to presentation to the University of Michigan Center for Vulvar Diseases. Study subjects were all given a diagnosis of vulvar Dysesthesia/vestibulodynia. Women without complaints of vulvar pain presenting to a gynecology clinic were enrolled as controls. Information was obtained from the control subjects using a questionnaire similar to the history forms completed by the study group. RESULTS: Comparisons were made between 242 patients with vulvar Dysesthesia/vestibulodynia presenting to a specialty clinic and 113 controls. Cases were more likely to be Caucasian, to be married and to have a higher household income than controls but reported less drug or alcohol abuse and a lower frequency of sexual intercourse. After controlling for possible confounders, no relationship between sexual assault and the presence of vulvar Dysesthesia/vestibulitis was found. CONCLUSION: The prevalence of victimization was not higher in patients with vulvar Dysesthesia/vestibulodynia as compared to the control population after controlling for potential confounding variables. Language: en

Shuji Kaneko - One of the best experts on this subject based on the ideXlab platform.