ORIGINAL RESEARCH—PAIN A Prospective Study of Pelvic Floor Physical Therapy: Pain and Psychosexual Outcomes in Provoked Vestibulodynia Corrie Goldfinger, MSc,* Caroline F. Pukall, PhD,* Evelyne Gentilcore-Saulnier, MSc, † Linda McLean, PhD, † and Susan Chamberlain, MD ‡ *Department of Psychology, Queen’s University, Kingston, ON, Canada; † School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada; ‡ Kingston General Hospital and Department of Obstetrics and Gynaecology, Queen’s University, Kingston, ON, Canada DOI: 10.1111/j.1743-6109.2009.01304.x ABSTRACT Introduction. Research suggests that increased tension in the pelvic floor muscles of women with provoked vesti- bulodynia (PVD, the most common form of chronic vulvar pain) may play an important role in maintaining and exacerbating their pain. However, no prospective studies of pelvic floor physical therapy (PFPT) for PVD have been carried out. Aim. This study prospectively examined the effectiveness of a PFPT intervention in treating the pain and sexual and psychological components of PVD, and determined predictors of greater treatment success. Methods. Thirteen women with PVD completed eight sessions of PFPT. Participants were assessed at pre- and post-treatment via gynecological examinations, vestibular pain threshold testing, structured interviews, and stan- dardized questionnaires. A 3-month follow-up interview assessed any further changes. Main Outcome Measures. Outcome measures included: vestibular pain thresholds, gynecological examination and intercourse pain ratings, sexual function and intercourse frequency, mental health, negative pain cognitions, and success rates. Results. Following treatment, participants had significantly higher vestibular pain thresholds and significantly lower pain ratings during the gynecological examination. Participants reported significant reductions in pain intensity during intercourse and were able to engage in significantly more pain-free activities. Although overall sexual function significantly improved, various components of sexual function and frequency of intercourse did not. Participants’ mental health did not significantly improve; however, pain catastrophizing and pain-related anxiety significantly decreased. The treatment was considered to be successful for 10 of the 13 participants, and predictors of greater treatment success included greater reductions in helplessness and a longer period of time in treatment. Conclusions. Results provide preliminary support for the effectiveness of PFPT in treating the pain of PVD, as well as some of the sexual and cognitive correlates of PVD. The results also indicate the need for large-scale, randomized studies of the effectiveness of PFPT in comparison and in conjunction with other treatment options. Goldfinger C, Pukall CF, Gentilcore-Saulnier E, McLean L, and Chamberlain S. A prospective study of pelvic floor physical therapy: Pain and psychosexual outcomes in provoked vestibulodynia. J Sex Med 2009;6:1955–1968. Key Words. Vulvodynia; Provoked Vestibulodynia; Dyspareunia; Physical Therapy; Pain; Psychosexual Factors Introduction P rovoked vestibulodynia (PVD; formerly known as vulvar vestibulitis syndrome) is the most common form of chronic vulvar pain affect- ing approximately 12% of premenopausal women in the general population [1]. The pain of PVD is commonly described as a sharp or burning sensa- tion at the vulvar vestibule (i.e., entrance of the vagina) in response to contact or pressure [2], and 1955 © 2009 International Society for Sexual Medicine J Sex Med 2009;6:1955–1968