Research

The BC Center for Vulvar Health is actively engaged in ongoing clinical research.

This includes research on the etiology (causes), natural history of the various types of vulvar diseases, and how to most effectively and efficiently treat this group of conditions and the negative impact of these conditions on overall health. Our goal is to not only publish findings of our work but to include new information into our treatment model- we will stay on top of current trends in clinical care and ensure that our patients get the very best care.

If you are interested in participating in clinical research, please confirm when you check in for your first appointment. Not only can you benefit from novel treatment approaches but the more participants that we have means a larger baseline of information for our research to learn from.

Publications

Peer-reviewed Publications
  • Mendlowitz, A. R., Hoang, L. N., McAlpine, J. N., & Sadownik, L. A. (2022). Differentiated Exophytic Vulvar Intraepithelial Lesions: Case Reports and Review of Literature. Journal of Lower Genital Tract Disease. 26(3), 283-286.  doi: 10.1097/LGT.0000000000000678. PMID: 35467577.
  • Jamieson, A., Tse, S. S., Brar, H., Sadownik, L. A., & Proctor, L. (2022). A Systematic Review of Risk Factors for Development, Recurrence, and Progression of Vulvar Intraepithelial Neoplasia. Journal of Lower Genital Tract Disease, 26(2), 140-146. doi: 10.1097/LGT.0000000000000662. PMID: 35249976.
  • Dayan, R., Sadownik, L., & Reutter, J. (2021). Vulvar Crohn disease. Canadian Medical Association Journal, 193(11), E379. doi: 10.1503/cmaj.190112. PMID: 33722830; PMCID: PMC8096402.
  • Smith, K. B. Koert, E., Maher, C., Eshtiaghi, P., & Sadownik, L. A. (2020). The Impact of Chronic Vulvar Dermatoses on Women’s Quality of Life: A Qualitative and Exploratory Study. Journal of Sexual Medicine, 17(9), 1740-1750. doi: 10.1016/j.jsxm.2020.06.016.
  • Bao, C., Noga, H., Allaire, C., Williams, C., Bedaiwy, M. A., Sadownik, L. A., Brotto, L. A., Smith, K. B., & Yong, P. J. (2019). Provoked Vestibulodynia in Women with Pelvic Pain. Sexual Medicine, 7(2), 227-234. doi:10.1016/j.esxm.2019.03.002
  • Smith, K. B., Seal, B. N., Sadownik, L. A., & Brotto, L. A. (2019). The Impact of Multidisciplinary Treatment on Psychological Functioning and Sexual Penetration among Women with Provoked Vestibulodynia. Journal of Gynecology and Women’s Healthcare, 2(1), 1-9.
  • Smith, K. B., Sadownik, L. A., Dargie, E., Albert, A. Y. K., & Brotto, L. A. (2019). Multidisciplinary Treatment for Provoked Vestibulodynia. The Clinical Journal of Pain, 35(4), 335-344. doi: 10.1097/AJP.0000000000000682.
  • Smith, K. B., Basson, R., Sadownik, L. A., Isaacson, J., Brotto, L. A. (2018). Antenatal vulvar pain management, labour management, and postpartum care of women with vulvodynia: A survey of physicians and midwives. Journal of Obstetrics  and Gynaecology of Canada. 40(5), 579-587. doi: 10.1016/j.jogc.2017.09.014.
  • Sadownik, L. A., Yong, P. J., Smith, K. B. (2018). Systematic review of treatment outcome measures for vulvodynia. Journal of lower genital tract disease, 22(3), 251-259. doi: 10.1097/LGT.0000000000000406.
  • Sadownik, L. A., Smith, K. B., Hui, A., & Brotto, L. A. (2016). The impact of a woman’s dyspareunia and its treatment on her intimate partner: A qualitative analysis. Journal of Sex & Marital Therapy, 43(6), 529-542. doi: 10.1080/0092623X.2016.1208697.
  • Smith, K. B., Sadownik, L. A., Basson, R., Isaacson, J., Brotto, L. A. (2016). Clinicians’ Perspectives and Experiences Regarding Maternity Care in Women With Vulvodynia. Journal of Obstetrics and Gynaecology Canada. 38(9), 811-819. doi: 10.1016/j.jogc.2016.04.008.
  • Lester, R. A., Brotto, L. A., Sadownik, L. A. (2015). Provoked vestibulodynia and the health care implications of comorbid pain conditions. Journal of Obstetrics & Gynaecology Canada, 37(11), 995-1005. doi: 10.1016/s1701-2163(16)30049-4.
  • Yong, P., Sadownik, L. A. & Brotto, L. A. (2015). Concurrent deep-superficial dyspareunia: prevalence, associations, and outcomes in a multidisciplinary vulvodynia program. Journal of Sexual Medicine, 1, 219-227. doi: 10.1111/jsm.12729.
  • Brotto, L. A., Yong, P., Smith, K. B. & Sadownik, L. A. (2015). Impact of a multidisciplinary vulvodynia program on sexual functioning and dyspareunia. Journal of Sexual Medicine, 12(1), 238-247. doi: 10.1111/jsm.12718.
  • Sadownik, L. A. (2014). Etiology, diagnosis, and clinical management of vulvodynia. International Journal of Women’s Health, 6, 437–449. http://doi.org/10.2147/IJWH.S37660
  • Brotto, L. A., Sadownik, L., Thomson, S., Dayan, M., Smith, K. B., Seal, B. N., Moses, M., & Zhang, A. (2014). A comparison of demographic and psychosexual characteristics of women with primary versus secondary provoked vestibulodynia. Clinical Journal of Pain, 30(5), 428-435. doi: 10.1097/AJP.0b013e31829ea118.
  • Sadownik, L. A., Seal, B. N., & Brotto, L. A. (2012). Provoked Vestibulodynia—Women’s experience of participating in a Multidisciplinary Vulvodynia Program. Journal of Sexual Medicine, 9, 1086–1093. doi: 10.1111/j.1743-6109.2011.02641.x.
  • Sadownik, L. A., Seal, B. N., & Brotto, L. A. (2012). Provoked Vestibulodynia: A qualitative exploration of women’s experiences. BC Medical Journal, 54, 22-28.
Conference Presentations
  • Altas, M. (2022, May 27). Menopause & Sexuality. VGH/UBC Hospital Foundation / Leslie Diamond Women's Health Luncheon.
  • Dehaeck, U. (2022, May 11). Top five secondary causes of itch in patients diagnosed with vulvar Lichen Sclerosus. Lichen Sclerosus Support Network, Holistic Healing Summit.
  • Altas, M. (2019, April 19). Provoked Vulvodynia. Pain BC / BC Echo.
  • Altas, M. (2022, March 31). Improving Access to Care in the Community for Individuals with Vulvodynia. Fred Bryans UBC OB/GYN research conference.
  • Yong, P. (2021, June 23). When sex hurts and it’s unexpected (the reproductive years). Panel Discussion: Society of Obstetricians and Gynaecologists of Canada.
  • Dehaeck, U. (2022, June 22). Recognizing and Treating Erosive Vaginitis. Society of Obstetricians and Gynaecologists of Canada Annual Clinical and Scientific Conference.
  • Dehaeck, U. (2021, May 18). Considerations in Colposcopy for Immunocompromised Patients [Webinar]. Society of Canadian Colposcopies.
  • BC Centre for Vulvar Health (2022, March 11-12). Annual Vulvovaginal Health Update, Virtual Conference.
  • Yong, P. (2021, March 5-7). Sexual Pain and Dyspareunia [Symposium]. ISSWSH – Co-Chair.
  • Altas, M. (2021, February 27). Vulvar Health. Division of Continuing Professional Development and VGH Department of Family Practice’s Annual Post Graduate Review Conference.
  • Mendlowitz, A. (2021, January 30). The 3 Lichens [Virtual conference session]. Victoria Gynecology Update.
  • Altas, M. (2021, January 22). Diagnosing and Managing Vulvar Pain [Webinar]. Pain BC.
  • Dehaeck, U. (2020, October 18). Recognizing and treating erosive vaginitis [Virtual conference]. 46th Annual D.A. Boyes Society Meeting & Obstetrics and Gynaecology Clinical Review.
  • Altas, M. (2020, October 18). Benign Vulvar Disease.  International Federation of Gynecology and Obstetrics.
  • Dehaeck, U. (2020, October 2). The vulva after menopause; atrophy or vaginitis. University of British Columbia, CME on the Run.
  • Altas, M. (2020, October 2). Sexual Health in Breast Cancer Survivors [Conference session]. Clinical Pearls: Breast and Prostate Cancer Survivorship Conference.
  • Altas, M. (2020, September 18). Sexual Health for Breast Cancer Survivors [Conference session]. University of British Columbia Department of Urology Conference.
  • Altas, M. (2020, February 27). Vulvar Health [Conference session]. UBC Family Practice’s Annual Post Graduate Review Conference.
  • Sadownik, LA. (2019, September). Assessment and Treatment of Vulvovaginal Atrophy. International Society for the Study of Vulvar Diseases, World Scientific Congress, Turin, Italy.
  • Sadownik, LA. (2019, September). Evidence-based 2nd Line Treatment Options for Lichen Sclerosus and Lichen Planus. International Society for the Study of Vulvar Diseases, World Scientific Congress, Turin, Italy.
  • Dehaeck, U. (2019, April). The Vulvar Exam, Normal or Not [Conference session]. BC College of Family Physicians & Society of General Practitioners Family Medicine Conference.
  • Dehaeck, U. (2019, April). Gynecological considerations in SJS/TENS, Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis 2019: From Science to Translation.
  • Altas, M. (2019, February). Vulvar Dermatoses: What to Manage, What not to Miss. UBC Annual Postgraduate Review in Family Medicine.
  • Sadownik, LA. (2018, December 7). Medical Management of Vulvodynia & How to Set Up a Vulvar Pain Clinic. 6th Biennial Scientific Session of the North American Capter of the ISSVD, Montreal, QC, Canada.
  • Dehaeck, U. (2018, November). Vulvar Treatment Pitfalls [Conference session]. St. Paul’s Continuing Medical Education Conference.
  • Sadownik, LA. (2018, November). Management of Vulvodynia. 45th D.A. Boye’s Society Meeting, Morris JWosk Centre for Dialogue, Vancouver, BC, Canada.
  • Altas, M. (2018, June). Practical Approach to Vulvar Pruritus [Conference session]. Society of Obstetricians and Gynaecologists of Canada Annual Conference.
  • Altas, M. & Dehaeck, U. (2018, May). Vulvology 101. UBC CPD Vulvovaginal Health Update, Vancouver, BC, Canada.
  • Sadownik, LA. (2018, May). What is normal? Which Lichen is it? Interesting Vulvar cases. UBC CPD Vulvovaginal Health Update, Vancouver, BC, Canada.
  • Dehaeck, U. Sadownik, LA. (2017, November). Vulvar Ulcers. DA Boyes.
  • Dehaeck, U. (2017, April). Vulvar Health. UBC CPD Sexual Health.
  • Sadownik, L. A. (2015, 8 October). Update on vulvodynia. XXI World Congress Federation of International Gynecologists and Obstetricians (FIGO), Vancouver, BC, Vancouver.
  • Brotto, L. A. (2014, February 27). Is it all in my head? Multidisciplinary Treatment of Provoked Vestibulodynia. Department of Ob/Gyn, Queen’s University, Kingston, ON, Canada.
  • Brotto, L. A. & Sadownik, L. A. (2013, June 14). Vulvodynia: Development of a Multidisciplinary Vulvodynia Program. Society of Obstetricians and Gynaecologists of Canada annual clinical meeting, Calgary, AB, Canada.
  • Sadownik, L. A. (2011, September). Vulvar dermatoses: Lessons learnt from the Multidisciplinary Vulvodynia Program. Invited presenter: Meeting of the Seattle Gynecologic Society, Seattle, WA, Unites States.
  • Brotto, L. A. (2011, June). Mindfulness in the treatment of women’s sexual difficulties. Invited plenary address, World Association of Sexology, Glasgow, Scotland.

Paper Presentations
  • Altas, M., Sadownik, L., Yong, P., Smith, K., Marsh, A. (2021, July). Is the Multidisciplinary Vulvodynia Program Achieving the Program’s Goals? XXVI World Congress and International Vulvovaginal Disease Update, Dublin, Ireland.
  • Smith, K. B., Sadownik, L. S., Basson, R., & Brotto, L. A. (2015, November). Pregnancy and childbirth among women with chronic genital. Pregnancy and the Mind Research Symposium, Vancouver, BC, Canada.
  • Yong, P., Sadownik, L., & Brotto, A. (2014, June). Concurrent deep-superficial dyspareunia: prevalence, associations, and outcomes. Annual meeting of the Society for Obstetrics and Gynaecologists of Canada, Ottawa, ON, Canada. Winner, Best Oral Presentation (Gynecology).
  • Sadownik, L., Van Tongeren, C., Smith, K., Basson, R., & Brotto, L. A. (2013, October). Partner’s perspective of the impact of provoked vestibulodynia. Congress of the International Society for the Study of Vulvar Diseases, Royal Caribbean Cruise, Mediterranean.
  • Van Tongren, C., Sadownik, L. Smith, K., Basson, R., & Brotto, L. (2013, March). Provoked Vestibulodynia and impact on the relationship: A partner’s perspective. UBC Department of Obstetrics and Gynaecology, Annual Academic Day, Vancouver, BC, Canada.
  • Brotto, L. A. (2012, May). A multidisciplinary vulvodynia program for treating women with Provoked Vestibulodynia. Canadian Pain Society, Whistler, BC, Canada.
  • Moses, M. H., Brotto, L. A., Smith, K. B., Sadownik, L. A., & Thompson, S. (2012, February). Seeking treatment for provoked vestibulodynia: A descriptive analysis of previous healthcare experiences. International Society for the Study of Women’s Sexual Health, Jerusalem, Israel.
  • Moses, M. H., Brotto, L. A., Smith, K. B., Sadownik, L. A., & Thompson, S. (2011, September). Patient characteristics and previous health care experiences among women seeking treatment for provoked vestibulodynia. Canadian Sex Research Forum, Vancouver, BC, Canada.
  • Sadownik, L. A., Brotto, L. A., Seal, B. N., Dayan, M., & Thomson, S. (2011, September). Impact of a Multidisciplinary Vulvodynia Program on women with Provoked Vestibulodynia. International Society for the Study of Vulvar Diseases Scientific Congress, Paris, France.
  • Brotto, L. A. (2011, June). Mindfulness-based CBT and women’s sexual dysfunction: applications for low desire, sexual distress, and provoked vestibulodynia. World Association of Sexology, Glasgow, Scotland.
  • Sadownik, L A., Brotto, L. A., Seal, B., Dayan, M., & Thomson, S. (2011, June). Provoked Vestibulodynia: A retrospective study of women’s experiences before diagnosis. Paper presented at the Annual meeting of the Society for Obstetrics and Gynaecologists of Canada, Vancouver, BC, Canada.
  • Brotto, L. A., & Sadownik, L. A. (2011, May). Multidisciplinary Vulvodynia Program: Patient characteristics and program efficacy. Grand Rounds presentation to the UBC Department of Obstetrics and Gynaecology, Vancouver, BC, Canada.
  • Sadownik, L. A., & Brotto, L. A. (2009, September). Provoked Vestibulodynia: An exploration of experiences. Paper presented at the International Conference for the Study of Vulvar Diseases, Edinburgh, Scotland.

Poster Presentations
  • Altas, M., Sadownik, S., Yong, P., & Marsh, A. (2021, July). Lessons Learned by the Multidisciplinary Vulvodynia Program. XXVI World Congress and International Vulvovaginal Disease Update, Dublin, Ireland.
  • Smith, K. B., Brotto, L. A., Basson, R., & Sadownik, L. (2014, April). Pregnancy and childbirth fears and reproductive intentions in women with provoked vestibulodynia. Society for Sex Research and Therapy, 39th annual meeting, Pittsburgh, PA, United States.
  • Smith, K. B., Brotto, L. A., Therrien, S., Basson, R., & Sadownik, L. (2014, October). Fear of child birth among women with provoked vestibulodynia. Canadian Sex Research Forum. Kingston, ON, Canada.
  • Jackowich, R. A., & Brotto, L. A. (2014, October). Associations of dyspareunia, sexual functioning, and sexual well-being in women diagnosed with provoked vestibulodynia and a history of sexual assault. Canadian Sex Research Forum, Kingston, ON, Canada.
  • Smith, K. B., Brotto, L. A., Sadownik, L., Basson, R., & Goldsmith, K. (2012, March). A review of pregnancy and childbirth outcomes in vulvodynia. Society for Sex Therapy and Research, Chicago, IL, USA .
  • Sadownik, L. A., Brotto, L. A., Seal, B. N., Dayan, M. & Thomson, S. (2011, June). Impact of a Multidisciplinary Vulvodynia Program on women with Provoked Vestibulodynia. Society for Obstetrics and Gynaecologists of Canada, Vancouver, BC, Canada.

Current Studies


The BC Centre for Vulvar Health is active in several research studies.
If interested in more information please contact us at BCCVH@vch.ca


Improving access to care for individuals with vulvodynia by supporting family physicians: Development of an online primary care toolkit.

Vulvodynia, a distressing vulvar pain condition, is frequently unrecognized and undertreated. The overarching goal of our project is to improve access to care for individuals with vulvodynia by supporting primary care physicians. A recent needs assessment, including a survey and focus group of province-wide community health care providers, identified a number of barriers to care including: 1) awareness and education, 2) accessible patient resources, 3) clear and concise treatment guidelines and 4) pathway to access vulvodynia – aware specialists. In partnership with community health care providers (physicians, physiotherapists and psychologists) and patient partners we will develop an accessible online toolkit to guide diagnosis and management.


VIVID Study

Vaginismus (fear of painful vaginal penetration) is common and affected individuals experience difficulties with vaginal intercourse and gynaecological exams, as well as diminished sexual desire, sexual dissatisfaction, and poor sexual self-efficacy. Unfortunately, available psychological treatments are not very effective. However, exposure therapy (insertion of vaginal dilators in the presence of a clinician), is highly effective, but unavailable in Canada. To fill this gap, we are exploring the potential of virtual reality exposure for the treatment of Vaginismus. Click on link for more information. https://brottolab.med.ubc.ca/studies/vivid/


Development of a Core Outcome Set for Vulvar Intra-epithelial Neoplasia; a Delphi Study with Engagement of Both Health Care Professionals and Patients.

The objective of this study are to systematically evaluate the literature regarding treatment outcomes for vulvar intra-epithelial neoplasia. Specifically to develop, disseminate and implement a (1) multidimensional patient data set (demographic, clinical, biological characteristics) and, (2) a VIN core outcome set (COS).


Delivering personalized care to women with vulvodynia: The integration of an electronic patient assessment questionnaire into the clinical setting.

The purposes of this research study are 1) to create a patient registry for women with chronic vulvar pain; 2) to evaluate the clinical utility of a newly validated tool, the Vulvar Pain Assessment Questionnaire (VPAQ). The data registry for the BC Centre for Vulvar Health is being created to collect clinical and questionnaire data from patients referred to the BC Centre for Vulvar Health on an ongoing basis. This will allow the Centre to follow women’s treatment progress and help to determine whether and how patients improve after being seen at the clinic.

Collaborators


UBC Sexual Health Research Lab

UBC Sexual Health Research focuses on clinical and behavioural research in women’s sexual health, including sexual difficulties, discrepancies, and distress. Our research aims to develop and test psychological interventions for the management of genital pain and low sexual desire causing significant personal distress.We also examine different aspects of sexual orientation, including asexuality. Dr. Lori Brotto and colleagues have published landmark studies differentiating asexuality from sexual dysfunction. This and our current line of research are aimed at exploring the neural and biological correlates of asexuality as a unique sexual orientation.

Sexuality is an integral aspect of well-being and strongly influences relationship happiness. However, too often individual, relational, environmental, political, cultural, and medical factors get in the way of healthy sexuality. Our driving goal is to identify and mitigate these forces so as to cultivate each woman’s own human sexual potential.https://brottolab.med.ubc.ca/

SWell Lab

The Sexuality and Well-being lab (SWell Lab) is a research laboratory in the Psychology Department at the University of British Columbia. We are a group of psychological scientists who conduct multi-method research to identify risk and protective factors contributing to individuals’ and couples’ sexual health and well-being.https://swelllab.psych.ubc.ca/

Dr. Sarah B Munro

Dr. Munro’s program of research focuses on investigating the factors that influence implementation of evidence-based innovations in women’s health care. She leads integrated knowledge translation studies on implementation of shared decision-making tools for use in the childbearing year and best practices in family planning. Dr. Munro also develops and tests tools that support effective patient-oriented knowledge translation, including decision aids and short documentaries.https://obgyn.ubc.ca/person/sarah-munro

Queen’s SexLab

SexLab is devoted to sexual health research, with the goal of contributing scientific knowledge to further our understanding of sexual health. We are an inclusive, collaborative, and sex positive group with a keen interest in clinical practice and knowledge translation.We work with patient partners and gender/sex minority consultants to ensure relevance of our research questions and inclusiveness of language used in our studies.Lab members also represent a variety of minority and underrepresented identities and statuses, and we contribute to each research study. Representation is essential since the majority of psychological research is dominated by sexual and gender/sex (and other) majorities.
https://www.sexlab.ca/