Assessing Sensory Perception on the Vulva and on Extragenital Sites

Quantitative sensory testing (QST) measures perception thresholds of defined intensities of physical stimuli (e.g. temperature, touch, pressure, vibration). The frequency and severity of subjective sensory effects (itch, burn), though less quantifiable, can be characterized under defined conditions such as product testing. This article reviews two sources of published research on sensory perception on the vulva relative to extragenital sites: (1) systematic, quantitative sensory testing with defined stimuli and (2) vulvar sensory effects reported in clinical trials of external feminine hygiene products. In healthy women, the vulva is less sensitive to punctate touch and vibration than other body sites. Vulvar sensitivity to mechanical stimuli declines after menopause, but is restored by estrogen supplementation. Product trials of feminine wet wipes suggest that vulvar perception of stinging and of skin wetness also are attenuated after menopause, although perceptions of burning or itching appeared to be unaffected. More systematic, standardized conditions are needed to validate the continued use of QST on the vulva and to better define the characteristics and intensity of subjective vulvar sensations.