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Thank you for taking the time to complete our quick survey! 
Your response will help us better understand how vulvodynia relates to other chronic pain conditions.
This survey is only for women who have been diagnosed with vulvodynia by a health care provider.
If you have yet to be diagnosed, please refrain from completing the survey.  Thank you!

Survey questions for women
who have been diagnosed with vulvodynia:

What is your age?   years

Email Address: *

Which subtype of vulvodynia have you been diagnosed with?


Something Else      Please Specify:

How long ago were you diagnosed with vulvodynia? months

Has a health care provider diagnosed you with any of the following conditions?
(please check all that apply)


  If yes, did your IC symptoms start before or after the vulvodynia?
   
  If yes, did your fibromyalgia symptoms start before or after the vulvodynia?
   
  If yes, did your CFS symptoms start before or after the vulvodynia?
   
  If yes, did your IBS symptoms start before or after the vulvodynia?
   
  If yes, did your endometriosis symptoms start before or after the vulvodynia?
   
  If yes, did your TMD symptoms start before or after the vulvodynia?
   
  If yes, did your chronic headaches start before or after the vulvodynia?
   
  If yes, did your BMS symptoms start before or after the vulvodynia?

Have you been diagnosed with any other chronic medical conditions?  
   If yes, please list:  

* required

The National Vulvodynia Association (NVA) is an educational, nonprofit organization founded to disseminate information on vulvodynia. The NVA recommends that you consult your own health care practitioner to determine which course of treatment or medication is appropriate for you.

Last Updated on July 7, 2010