Facing the uncertainty of vulvodynia: a qualitative study of barriers and protective factors in the Italian context.

Vulvodynia is chronic vulvar pain that affects 15% of women aged 18-70. This condition is characterised by great uncertainty: the aetiology remains unclear, the diagnostic process is difficult and there is a lack of rehabilitation programmes. These characteristics may lead to the patient's pain being socially delegitimised or attributed to a psychological origin. As vulvodynia disrupts daily activities and sexual function, it affects women's self-perception, causing depression, anxiety and other negative emotions. Using a qualitative descriptive approach, this study aims to explore patients’ experiences in the Italian context. Indeed, people's cultural background strongly influences meanings and beliefs about chronic pain and sexual problems. A second aim is to investigate the influence of family and social relationships on the management of vulvodynia. Thirty-five semi-structured interviews were conducted with participants aged 18-50. The analysis identified four main themes: A disabling pain; Aggravating factors: experiences of lack of support and delegitimisation; Protective factors: experiences of coping and empowerment; An incomplete woman. The study confirmed a clear lack of medical knowledge, resulting in challenges to acquire an accurate diagnosis and medical treatment. Furthermore, women's unmet expectations of familial support amplified their sense of abandonment. However, two key factors lessened the uncertainty regarding vulvodynia management. Firstly, women were able to find alternatives to penetrative sex, gaining more confidence in themselves and their sexuality, even though vulvodynia’s limitations undermined their identity. Secondly, they developed stronger relationships in online patient groups, where they found answers to their information and emotional needs reducing their loneliness.