(053) Efficacy of Mindfulness Based Cognitive Therapy in Management of Provoked Vulvodynia: A Feasibility Pilot Study

Abstract:

Introduction: Provoked Vulvodynia (PVD) is an evolving and chronic pain disorder frequently reported by women of reproductive age. Provoked Vulvodynia is a debilitating disorder and causes significant impairment in daily functioning.

Objective: The present study was designed with an aim to compare the efficacy of mindfulness based cognitive therapy (MBCT) with pharmacotherapy in the management of PVD in Pakistani women.

Methods: The present study was approved by the Ethics Review Board (ERB) of Institute of Psychological Research, Pakistan vide No. IPR/ERB/PVD/2023/006. A randomized trial design was used in this study. The women suffering from vulvodynia were included in the study. On the other hand, the women suffering from any gynecological disease, psychiatric disease, or any other medical disease or using any substance were excluded from the study. A total of 43 women suffering from PVD were referred for the treatment. 14 women were excluded as they did not meet the inclusion criteria. All women signed the compulsory informed consent form before enrolling for the study. 29 women were randomized in two treatment groups namely Group A which received 1 hour weekly session of mindfulness based cognitive therapy and Group B which received pharmacotherapy for a period of 3 months. Pharmacotherapy included Amitriptyline 25–50mg daily, Gabapentin 100–300 mg daily, and Lidocaine ointment 5% applied locally to the vestibule. There were 14 women in Group A and 15 women in Group B. A total of 6 women were dropped from the Group A and Group B because they did not want to complete the treatment protocol. 11 women in Group A and 12 women in Group B completed the treatment protocol and their data were added to the statistical analyses. The Vulvar Pain Functional Questionnaire (V-Q) was used as the main outcome measure for pretest and posttest assessments. The data was analyzed by using the Statistical Package for the Social Sciences (SPSS) version 27.

Results: The mean age of the women was (M=34, SD=3.13) for Group A and (M=34.41, SD=3.26) for Group B. The data was analyzed by using the Wilcoxon Signed Rank Test as the data was non parametric. There was statistical significant Z= -2.94, p<.05 for Group A and Z= -3.07, p<.05 for Group B. The results established that both mindfulness based cognitive therapy and pharmacotherapy were effective in relieving symptoms of PVD.

Conclusions: The present study concluded that mindfulness based cognitive therapy was as effective in relieving symptoms of PVD as pharmacotherapy. The lack of control group was a major limitation of the study. However, the future studies may be conducted with other treatment arms such as pelvic floor therapy and by adding more women in treatment and control groups. The present study may be considered as a feasibility/pilot study for the efficacy of MBCT for treatment of PVD in Pakistani women. Disclosure: No.