Vulvodynia is a chronic condition that affects the vulva with no clear cause, causing pain, burning, or irritation that lasts at least three months. Researchers believe that the development of pain-related systems in those diagnosed with vulvodynia may be caused by alterations in the central nervous system and the peripheral nervous system. Specifically, previous research suggests the pain experienced from vulvodynia is a result of central sensitization, which is the hypersensitivity of areas in the brain that are responsible for acute pain processing.

Interoceptive sensibility is described as the ability to notice what’s happening inside the body. Researchers believe that those with higher expressions of interoceptive sensibility may be more efficient in regulating symptom-related distress. Rather, stronger interoceptive sensibility would supposedly lead to less perceived unmanageable pain.

To test if interoceptive sensibility plays a role in central sensitization symptoms, researchers collected data from 104 Italian women between 2022 and 2023. Women were screened for vulvodynia by a gynecologist and then asked to complete a series of questionnaires that assessed sexual functioning, interoceptive sensibility, central sensitization symptoms, and emotional condition related to depression, anxiety, and stress.

Of these 104 women, 21.5% stated they were suffering from other pain-related conditions beyond vulvodynia (headaches, adenomyosis, endometriosis, pudendal neuropathy, etc.), and 65.8% stated they were sexually active. According to the results, those who were not sexually active (34.61%) experienced significantly higher levels of pain.

Results also show that there was a positive relationship between the Multidimensional Assessment of Interoceptive Awareness (MAIA) components of noticing (awareness of body sensations), not worrying (avoiding emotional distress from body sensations), and emotional awareness (connection between body and emotions), with the total central sensitization index score. Essentially, this means that women experience more hypersensitivity to pain when their ability to process bodily function in these areas is higher. Additionally, the trusting (experiencing the body as safe and trustworthy) component of the MAIA showed a negative correlation with central sensitization symptoms. Meaning, a higher level of trust in the body would lead to lower sensitivity to pain.

Researchers noticed lower scores in the MAIA areas of attention regulation (ability to control attention to the body), self-regulation (ability to regulate distress by caring for the body), and trusting. They believe this means women with vulvodynia may struggle to control how often they focus on bodily sensations. Basically, even though the women may have reported lower levels of emotional distress regarding their pain, they may actually be struggling to regulate any psychological distress caused by bodily sensations.

In short, lower levels of trust, and higher levels of emotional awareness would suggest a more intense hypersensitivity to vulvodynia pain, according to researchers. This may be linked to a higher tendency for women with vulvodynia to experience the body as unsafe and untrustworthy. Because a person’s ability to pay attention to their body’s needs contributes to the experience of pain, this could have significant negative effects on emotional states, such as depression or anxiety.

Despite a few limitations (sample size, wide age range, lack of controls), this study shows potential for helping explain the role of the mind and nervous system in vulvodynia pain reactions. Future research should involve multiple subgroups – including a control – and ensure age can be accounted for in data, amongst other points. Researchers state that the recognition of pain’s origin may help women to overcome psychological distress or perceived injustice from their brain and nervous system’s ability to process pain.

References:

• Scarpina, F., Navarra, M. E., Varallo, G., & Bernorio, R. (2025). The role of interoceptive sensibility on central sensitization to pain in vulvodynia. The Journal of Sexual Medicine, 22(3), 491–499. https://doi.org/10.1093/jsxmed/qdae203
• Mayo Foundation for Medical Education and Research. (2023, September 1). Vulvodynia. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/vulvodynia/symptoms-causes/syc-20353423