Assessment of Vulvodynia Symptoms in a Sample of U.S. Women: A Follow-up National Incidence Survey

Abstract

Objective: To estimate the annual incidence of vulvodynia-like symptoms and evaluate triggers of vulvar pain in a sample of U.S. women. Methods: After a 1-year interval, women who previously participated in a national vulvodynia prevalence study were recontacted and administered a telephone questionnaire that assessed self-reported vulvodynia-like symptoms and triggers of symptoms. Results: From the original cohort of 425 women, 285 (67%) participated in this follow-up study. Symptoms consistent with vulvodynia occurring within 1 year of initial contact were reported by 4.7% of previously asymptomatic women. Nearly 50% of the original patients again reported a history of vulvodynia-like symptoms, with 68.6% of these as persistent over the past year. Of significance, pain or discomfort with first-time tampon use was 2.15 times more likely (95% CI 1.0-4.62) in symptomatic women. These women were also 2.4 times more likely (95% CI 1.29-4.53) to use a combination of tampons and pads for sanitary protection rather than one method alone. Conclusions: Over the course of 1 year, as many as 1 in 20 women may experience new-onset chronic genital pain. Despite a higher likelihood of having discomfort or pain with first tampon use, symptomatic women did not exhibit a preference for sanitary napkins. This indicates that lack of tampon use because of pain may not be an effective screening criterion for vulvodynia. We recommend additional studies with symptomatic and diagnosed women to explore in more detail the issues surrounding tampon use history and chronic genital pain. 1285

Remission, Relapse, and Persistence of Vulvodynia: A Longitudinal Population-Based Study

“…7 Nguyen et al questioned women with screened and verified vulvodynia about periods in the past in which vulvar pain resolved (remission) and reported an overall remission rate of 33.0% (46/138). 26 However, by design, all women in their study had vulvar pain consistent with vulvodynia and hence all with a remission had subsequently relapsed, whereby those without a relapse would not have been within their study population.…”

“…6 Similarly, in a nationwide population-based study, Sutton et al found that 37 of 72 women meeting criteria for vulvodynia at their baseline survey denied ever having had these symptoms when asked a year later (51.4%). 7 We considered women with symptoms that resolved to have remitted in our analysis-even when they reported no previous symptoms, while Sutton et al excluded these women from their analysis, thereby explaining the lower remission rate (31.4%) they reported.…”

“…[2][3][4] A limited number of studies now have included a follow-up evaluation and have documented that not all women with vulvodynia continue to report such symptoms at follow-up, suggesting that remission does occur. [5][6][7] Clinical experience suggests that women who experience remission remain at high risk of relapsing symptoms. However, the rates of persistence, remission, and relapse are currently unknown, and the factors associated with these clinical trajectories have not been investigated.…”

“…7 We conducted a prospective study to more accurately measure the presence and absence of symptoms suggesting vulvodynia over time and to assess the frequency of persistence, remission, and relapse in a population-based study. A population-based approach captures the breadth of vulvodynia symptoms and clinical course present in the community.…”

Depression and Posttraumatic Stress Disorder Among Women with Vulvodynia: Evidence from the Population-Based Woman to Woman Health Study

“…1,2 Pain presentation varies and may be described as spontaneous, provoked by stimulation (i.e., intercourse or tampon use), or both. 1,3 While some studies have documented that women with vulvodynia report a poor quality of life 4,5 and suffer from psychological distress manifested as anxiety and depression, [6][7][8][9][10] evidence of an association between vulvodynia and mental health outcomes remains limited.…”