Vulvodynia: characteristics and associations with comorbidities and quality of life

Abstract

Objective: This case-control survey compared health history and health care use of women with vulvodynia with a control group reporting absence of gynecologic pain.

Methods: Women with a clinically assessed diagnosis of vulvodynia and asymptomatic controls were matched for age and mailed a confidential survey that evaluated demographics, health history, use of the health care system, and history of vulvodynia. Participants were all current or former ambulatory patients within a university health care system.

Results: Of the 512 questionnaires mailed to valid addresses, 70% (n = 91) of cases and 72% (n = 275) of controls responded, with 77 cases and 208 controls meeting eligibility criteria. Women with vulvodynia reported a substantial negative impact on quality of life, with 42% feeling out of control of their lives and 60% feeling out of control of their bodies. Forty-one percent indicated a severe impact on their sexual lives. When comorbidities were evaluated individually and adjusted for age, fibromyalgia (odds ratio 3.84, 95% confidence interval 1.54-9.55) and irritable bowel syndrome (odds ratio 3.11, 95% confidence interval 1.60-6.05) were significantly associated with vulvodynia. On a multivariate level, vulvodynia was correlated with a history of chronic yeast vaginitis and urinary tract infections.

Conclusion: This survey highlights the psychological distress associated with vulvodynia and underscores the need for prospective studies to investigate the relationship between chronic bladder and vaginal infections as etiologies for this condition. As well, the association of vulvodynia with other comorbid conditions, such as fibromyalgia and irritable bowel syndrome, needs to be further evaluated.

Level of evidence: II-2.

Figure 1

Mailing disposition of surveys sent to 585 women.*Surveys mailed to women who signed consent for UMDNJ clinical vulvodynia studies; review of non-responders indicated that a diagnosis of vulvodynia was not confirmed in three women, so they were excluded from the non-responder analysis.^†A review of completed surveys from cases found that a UMDNJ clinician had not confirmed a diagnosis of vulvodynia in six women, and so they were excluded from the final analysis.