Pleasure despite pain: treatments for vulvodynia and a proposal for a multimodal intervention from a biopsychosocial perspective

Chronic vulvar pain is a common condition among women and, like other chronic pain conditions, it has a significant impact on quality of life, psychological well-being, and sexuality. Vulvodynia represents the most common form of chronic vulvar pain and is increasingly conceptualized as a complex and multifaceted condition, influenced by biological, psychological, sexual, and relational factors. Given the multifaceted nature of vulvodynia, recent literature highlights the importance of a multimodal intervention framework to promote a more comprehensive treatment, integrating medical care, pelvic floor rehabilitation, and psychological support. Although robust empirical evidence supporting multimodal models remains limited, preliminary findings and clinical considerations suggest that such an approach may represent a promising treatment option for women with vulvar pain. The present thesis provides a review of the literature regarding vulvodynia and sexuality, with a specific focus on psychological interventions that allow not only pain reduction but also improved sexual functioning and sexual satisfaction in women with vulvodynia. Building on a biopsychosocial perspective, the thesis further proposes a multimodal intervention model that integrates psychological treatment within a broader interdisciplinary framework.