What if the reason standard treatment for vulvodynia keeps falling short is that it addresses the body but ignores the rest of the picture?
Dr. Claudia Chisari is one of the most cited scientists in vulvodynia research and the founder of Bloume Health - a platform turning research insights into practical tools for people with pelvic pain. She has personal experience of years of pain and medical dismissal, which shaped the direction her research has taken. In this episode, Dr. Chisari explains the biopsychosocial model of pain as it applies to vulvodynia: why stigma, mental health, and relationship quality can directly influence pain outcomes, and what her research reveals about the role of acceptance and a sense of injustice in how people live with this condition.
The biopsychosocial model: what it means for vulvodynia treatment
The biopsychosocial model holds that pain - and health outcomes more broadly - are shaped by biological, psychological, and social factors interacting with each other. In the context of vulvodynia, this means that the hormonal, neurological, and muscular drivers of pain do not operate in isolation from a person's emotional state, their beliefs about what the pain means, their relationship quality, and their position in a social context that may be dismissive of their experience or that may carry significant shame about the body part affected.
This is not a claim that vulvodynia is "in the head" - Dr. Chisari is explicit about that. It is a claim that treating only the physical dimension of a condition that is shaped by multiple interacting factors will systematically underperform. The research evidence supports this: psychological and relational factors predict outcomes in vulvodynia in ways that biological factors alone do not account for.
"Genital pain is just so stigmatized. And I was just thinking about how much we have in common with other stigmatized conditions - and why the research hasn't moved as fast as it should have."
Stigma, mental health, and relationships as pain predictors
Dr. Chisari's research has examined the role of psychological acceptance - accepting the presence of pain without it dominating every decision and every sense of self - as a factor in how well people function with vulvodynia. The ACT (Acceptance and Commitment Therapy) framework, applied to chronic pain, involves moving toward valued activities and relationships even in the presence of pain, rather than organising life around pain avoidance. Her research has tested this approach specifically in the vulvodynia population and found meaningful effects.
She has also researched the role of perceived injustice - the sense that the pain is unfair, that it shouldn't be happening, that the medical system has treated one badly - on outcomes. A high sense of injustice is associated with worse outcomes: not because the sense of injustice is wrong (often it is entirely justified) but because of what it does to the nervous system and to the psychological work of adapting to chronic pain. This finding doesn't come without complexity, and Dr. Chisari discusses it with appropriate nuance.
"Injustice is particularly key in the context of vulvodynia and women's health, compared to maybe other conditions where there's more recognition and less invalidation. We've now worked on a study looking at chronic pelvic pain and the level of perceived injustice - it matters."
Dr. Chisari's own journey: from patient to researcher
The fact that Dr. Chisari has personal experience of vulvodynia and medical dismissal shapes everything about how she talks and what she researches. She is not approaching this from outside the experience. Her years of navigating a system that failed to take her pain seriously informed the questions she decided to ask as a researcher and the practical turn her work has taken with Bloume Health.
This combination - lived experience and rigorous research - makes her one of the most credible voices in the field for the people this podcast serves. She understands both what the research says and what the experience of actually living with this condition is like, and the episode holds both dimensions honestly.
"Oftentimes when you improve the impact pain has on your life, the pain reduces. And that's not to say that the pain is psychological. Of course not. I've had pain for years. I know it's not psychological. But these [psychosocial] factors really do matter."
Bloume Health: turning research insights into practical tools
Bloume Health is Dr. Chisari's attempt to close the gap between what research reveals and what actually reaches patients. The platform translates the findings of vulvodynia research into practical, accessible tools - addressing the psychological and relational dimensions of the condition alongside signposting for physical treatment.
For people who are looking for support that goes beyond physiotherapy and medication - who are dealing with the impact of chronic pain on their sense of self, their relationships, and their mental health - Bloume Health represents a direct practical resource built on the research evidence rather than generic wellness content. This episode is the best introduction to both the research behind it and the person who built it.
