(078) Characterization of Treatment Plans Prescribed to Patients With Vulvovaginal Pain Diagnoses in an Urban Sexual Health Clinic

Abstract Introduction Patients with vulvovaginal pain diagnoses are prescribed pharmacological treatment, referred for physical therapy, recommended procedural interventions, or a combination. Leading organizations promote an individualized, multidisciplinary approach. Though there is extensive research and guidelines supporting multidisciplinary care, there are limited studies on what treatment patterns are being carried out for pain diagnoses made in a sexual medicine clinic setting. Characterizing treatment modalities for patients with vulvovaginal pain diagnoses is crucial to better understand the needs of patients and to inform stakeholders of the needs for layered treatment plans. This may offer guidance for advocates to bridge the gaps created by economic, biologic, and social barriers to strategically increase access to resources. Objective This study aims to characterize what proportion of patients with vulvovaginal pain diagnoses receive pharmacologic, physical therapy, procedural intervention, or multifaceted treatment in an urban sexual medicine clinic. Methods This study conducted a retrospective chart review on patients who attended an OB/GYN-based sexual health clinic in Washington DC for a sexual health consult (SHC) between January 2022 and August 2025. Patients initially seen prior to 2022 or who were not seen for a SHC were excluded. Of data collected from 241 total patient charts, 216 patients met the criteria for this study. Results Of the 216 patients diagnosed with a vulvovaginal pain disorder, 37 patients (17.1%) were treated with pharmacologic therapy alone, while 35 patients (16.2%) were referred exclusively to pelvic floor physical therapy. Multifaceted care was the most common approach, with 87 patients (40.3%) receiving both pharmacologic treatment and a pelvic floor physical therapy referral. Additionally, procedural interventions - while not considered first-line treatments - were utilized when initial therapies were insufficient. 10 patients (4.6%) received procedural treatment recommendations alone, while 47 patients (21.8%) received procedural treatment in combination with pharmacologic therapy and/or pelvic floor physical therapy. Overall, 62.1% of patients received more than one treatment modality, whether through combined pharmacologic and pelvic floor physical therapy or through care plans that also incorporated procedural interventions. Conclusions The majority of patients with a pain diagnosis were treated with multifaceted care. However, the results characterize that despite guideline recommendations emphasizing multimodal management, individualized care is more complex, and as such, different combinations of treatment modalities are prescribed to patients in practice. Patients in this sexual health clinic were often diagnosed with conditions that required procedural treatment as well as pharmacological intervention. Navigating multimodal treatment plans can be difficult for patients to adhere to because of psychosocial, biological, and economic barriers. There are limited literature reviews focusing on the barriers patients face with adherence. Further studies should look to see if there are demographic or clinical differences in patients prescribed complex care plans and to extract data on psychology/psychiatry referral patterns. Disclosure No.