Histologic and receptor analysis of primary and secondary vestibulodynia and controls: a prospective study

Am J Obstet Gynecol. 2010 Jun;202(6):614.e1-8. doi: 10.1016/j.ajog.2010.01.028. Epub 2010 Apr 28.


Objective: The objective of the study was to assess the association between hormone receptor densities, pain nerves, and inflammation in vestibulodynia patients.

Study design: In a prospective study, tender and nontender biopsies from 10 primary and 10 secondary vestibulodynia patients were compared with biopsies in 4 nontender controls. Hormone receptors were evaluated using immunohistochemistry for estrogen receptor-alpha and -beta, androgen, and progesterone receptors. Inflammation, nerves, and mast cells were assessed histologically. Statistical analysis was by Fisher's exact test, analysis of variance, paired Student t test, and Wilcoxon rank test.

Results: Tender sites from primary vestibulodynia had increased nerve density compared with secondary and control biopsies (P = .01). Tender sites in secondary vestibulodynia had more lymphocytes than tender primary sites and control biopsies (P < .0001). Mast cells were increased in tender sites compared with nontender and controls. There were no differences in hormone receptor expression.

Conclusion: Markers of inflammation differed between primary and secondary vestibulodynia and controls.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Estradiol / blood
  • Estrogen Receptor alpha / metabolism
  • Estrogen Receptor beta / metabolism
  • Female
  • Humans
  • Immunohistochemistry
  • Inflammation / metabolism
  • Inflammation / pathology
  • Mast Cells / metabolism
  • Mast Cells / pathology
  • Middle Aged
  • Progesterone / blood
  • Prospective Studies
  • Receptors, Androgen / metabolism
  • Receptors, Progesterone / metabolism
  • Vulvodynia / metabolism*
  • Vulvodynia / pathology


  • Estrogen Receptor alpha
  • Estrogen Receptor beta
  • Receptors, Androgen
  • Receptors, Progesterone
  • Progesterone
  • Estradiol