Vulvar Pain and Mental Health: The Importance of Addressing Both
“Data suggest symptoms of physiological arousal (racing heart, sweating palms, dizziness) & experiencing negative thoughts & emotions, common symptoms in anxiety & depression disorders, may be associated with the maintenance or exacerbation of vulvar pain symptoms. Likewise, one or more aspects of the pain experience (physiological arousal, pain-related catastrophising, avoidance of physical exertion) may exacerbate clinically significant symptoms of anxiety & depression. Hence, it is plausible that the pathway between vulvodynia & psychological disorders such as anxiety, PTSD & depression, is bidirectional” 
Putting a Spotlight on the Research
As Vulva Pain Doctors are aware, studies show that women suffering from vulvodynia, may experience a higher level of brain activation in the areas of the central nervous system linked to sensory processing and pain. Of note, it had been determined that activation within the insula (a sensory integration region involved in sensory and pain processing, is connected to anxiety disorders including vulva pain and post-traumatic pain disorder . To that end, whenever you have a consultation with a Pain Specialist, they will review your medical history, and ask you pertinent questions about your vulva pain, as well as any psychological issues you have experienced, or are currently suffering.
Hormones & Neurotransmitters
Hormones/neurotransmitters, serotonin and noradrenaline, are known to be associated with depressive disorders and anxiety, and have been implicated in the underlying pathophysiology of long-term pain . Note: serotonin plays a main role in certain body functions such as mood, sleep, digestion, and sexual desire. And noradrenaline has a key role in the regulation of stress reactions, arousal, attention, cognitive function, and stress.
In a Nutshell
• Studies have indicated a strong link between suffering from post-traumatic stress disorder, and the risk of having vulvodynia
• Research has also highlighted a moderate link between depression and the risk of having vulvodynia 
Booking an Appointment With a Vulva Specialist
Whether you arrange an online or in-person vulvodynia consultation: besides your medical files, it is import to be prepared to give as much information to your Vulva Doctor as possible. To that end, compiling a daily ‘Pain & Mental Health Dairy,’ which is divided into 24 hour slots, will be of great benefit . So make entries whenever you are experiencing pain or mental health issues (such as stress, depression, and anxiety). And write down how long it lasted, if it is ongoing; and what you were doing before and after these pain and mental health issues came and went. Also note the degree of pain and psychological suffering. So for example: moderate pain in the vulva region for two hours, and continuous heavy feelings of anxiety all day and evening, and even waking up in the night feeling the same.
. Iglesias-Rios L, Harlow SD, Reed BD. Depression and posttraumatic stress disorder among women with vulvodynia: evidence from the population-based woman to woman health study. J Womens Health (Larchmt). 2015 Jul;24(7):557-62.