(079) Exploring the Relationship Between Trauma and Vulvovaginal Pain Disorders in an Urban Sexual Medicine Practice

Abstract Introduction Trauma, including physical, sexual, or emotional abuse, has been associated with various forms of pain during sexual activity. Prior trauma has been implicated in both the genesis and the severity of symptoms of vulvovaginal pain through complex biopsychosocial pathways. However, few studies have explored whether trauma history is associated with specific subtypes of vulvovaginal pain such as hormonally mediated vestibulodynia, neuroproliferative vestibulodynia, and hypertonic pelvic floor dysfunction. Evaluating these relationships may improve diagnostic accuracy, inform individualized treatment, and strengthen psychosocial models of care in sexual medicine. Objective To evaluate the association between documented trauma history and distinct pelvic pain diagnoses among patients presenting to an urban sexual medicine clinic. Methods A retrospective chart review was performed for new sexual health consultations conducted after 2022 at an OB/GYN-based sexual medicine clinic in Washington, D.C. Eligible encounters included patients seen by one of four designated sexual medicine providers who routinely screened for trauma. Five trained reviewers independently abstracted demographic, psychosocial, and diagnostic data from electronic medical records using a standardized qualtrics survey, no identifying information was entered into the survey. Data were exported to Excel for cleaning and verification. Associations between trauma history and pain diagnoses were analyzed using chi-square or Fisher exact tests. Results Of 251 records reviewed, 240 met inclusion criteria. Most patients identified as female and heterosexual, with ages spanning 19 to 79 years (mean 36 years). Sixty-eight patients (28.3%) had a documented history of trauma, 116 (48.3%) had no trauma history, and 56 (23.3%) did not comment on trauma history and were marked as “not specified.” Pain diagnoses were common overall with 72.9% of all patients receiving at least one pain diagnosis. Among those with a trauma history, 94.1% had at least one pain diagnosis compared with 95.7% for those without trauma history (Fisher’s exact p = 0.73). Sub-type analyses revealed no significant associations between trauma history and hypertonic pelvic floor dysfunction (82.3% vs. 73.2%, p = 0.16), hormonally mediated vestibulodynia (38.2% vs. 30.1%, p = 0.26), or neuroproliferative vestibulodynia (10.2% vs. 19.8%, p = 0.09). Conclusions In this cohort of patients seen for sexual health consultations, most received at least one pain-related diagnosis regardless of trauma history. Although patients with a history of trauma demonstrated slightly higher rates of hypertonic pelvic floor dysfunction and hormonally mediated vestibulodinia, these differences were not statistically significant. The high prevalence of pain diagnoses across groups likely reflects the specialized referral population rather than trauma-specific effects. Future studies should evaluate a larger population of patients with pain diagnosis and incorporate prospective designs to further examine the influence of trauma on distinct pain diagnoses. Disclosure No.