Vulvodynia Intervention: the Effect of Multimodal Treatment for Provoked Vulvodynia

Provoked pain during sexual and non-sexual activities. Seven activities where pain is rated on a scale from 0 to 10. Higher scoring indicates higher degree of pain. There are also subsequent questions regarding whether they have performed the described activity or not within a specific time frame.

The Female Sexual Function Index (FSFI) is a self-report measure of female sexual function that assesses six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. It consists of 19 questions, rated on a 5-point scale, with a higher score indicating a better sexual function.

Participants chose an individual treatment goal and rate treatment goal attainment, from 0-10, 0= the goal is not at all achieved, 10= the goal is achieved.

Self-report assessment of pelvic floor tension and pelvic floor relaxation. Two items rated on a 11-point scale, from 0-10, higher scores indicate greater tension and more difficulty relaxing the pelvic floor, and physiotherapeutic examination.

Global measure of sexual satisfaction (GMSEX), 5 items rated on a 7-point scale. Higher scores indicate a higher degree of sexual satisfaction.

Approach avoidance sexual goals (AASQ), self focused sexual goals and interpersonal sexual goals, 23 items rated on a 7-point scale, participants rates the importance of self focused or interpersonal reasons, influencing why they typically engage in sex. Higher scores indicates greater importance.

9 items regarding self and partner disclosure, partner responsiveness and closeness, rated on a 7-point scale, with higher scores indicating greater perceived intimacy.

Vulvar pain assessment questionnaire (VPAQ) Inventory is a disease-specific set of measurement scales to capture the biopsychosocial nature of vulvodynia. We are using the parts from the questionnaire that evaluates life interference, sexual function interference, impact on relationship and sexual communication.

Life interference: 11 items rated on a 6-point scale from 0 (not at all) to 4 (avoid because of pain). Higher scores indicating greater life interference.

Sexual function interference: 10 items rated on a 6-point scale from 0 (not at all) to 4 (avoid because of pain)

Impact on relationship: 6 items about intimacy and, general and sexual communication rated on a 5-point scale from much worse to much better. Higher scoring indicates that the vulva pain has lower impact on the relationship.

6 items about communication with partner rated on a 5-point scale from 0 (largely uncomfortable) to 4 (largely comfortable). Higher scoring indicates

Using the patient health questionnaire (PHQ-9), 9 items are rated on a 4-point scale, from 0 to 3. Higher scores indicating higher degree of depression symtoms.

Using the Generalized Anxiety Disorder questionnaire (GAD-7), 7 items rated on a 4-point scale from 0 to 3, higher scoring indicating a higher degree of anxiety symptoms.

World Health Organization Quality of Life-BREF, 1 item where participants rates their quality of life, on a 5-point scale from 1 to 5, higher scoring indicating greater quality of life.

Age, country of birth, educational level, occupation, if they have a partner/-s, how long they have been in that relationship/-s, gender of partner/-s, if they have kids, childbirth during the last year, ongoing pregnancy, menstruation

Two items from the female sexual function index, measuring sexual desire and arousal, rated on a 5-point scale. Higher scoring indicate greater sexual desire and arousal.

Pain catastrophizing scale (PCS) evaluates participants negative cognitive and emotional reactions to pain. It assesses the extent of catastrophic thinking due to pain according to three subscales: rumination, magnification and helplessness. 13 items rated on a 5-point scale from 0 (not at all) to 4 (all the time). Higher scores indicating greater levels of pain catastrophizing.

Two items from the CHAMP Sexual Pain Coping Scale (CSPCS), rated on a 7-point scale, with higher scores indicating a higher degree of avoidance and endurance.

Using the Sexual and Physical Abuse Questionnaire (SPAQ). 8 questions about experiences of sexual and physical abuse.

2 items rated on a 11-point scale, from 0 to 10. Higher scoring indicating higher expectations that this treatment will be helpful.

1-2 items measuring negative effects of the treatment. One questions that asks if the participant experienced any negative effects of the treatment, with a following question asking the participant to describe more in an open answer.

4 items rating potential improvement and satisfaction on a 6-point scale (1-6), higher scoring indicating greater improvement and satisfaction.

Using items from the CHAMP Sexual Pain Coping Scale, 12 items assess coping strategies for sexual pain: avoidance and endurance, rated on a 7 point-scale from 1 to 7, where higher scoring indicating a higher degree of avoidance and/or endurance.

Semi structured interviews, individual interviews and focus groups, probing qualitative aspects of the treatment experience, and the experience of implementation of patients, treating practitioners and clinical managers.