Vulvodynia More Common Than Previously Estimated

Laurie Barclay, MD

January 12, 2004

Jan. 12, 2004 — Vulvodynia is more common than previously estimated, and the prevalence is similar for African-American and white women, according to the results of an Internet survey published in the January issue of the Journal of Lower Genital Tract Disease.

"We used to think this was rare," lead author Barbara D. Reed, MD, MSPH, from the University of Michigan Health System in Ann Arbor, says in a news release. "It turns out it's much more prevalent than we thought: 3% of women report chronic pain and 1.7% currently have pain. That's millions of women across the United States."

Based on previous research, estimates of the number of women affected by vulvodynia were as low as 150,000. Between May 24, 2002, and June 6, 2002, e-mail surveys on women's health issues were completed by a random sample of 994 women aged 18 years or older who had enrolled in SurveySpot, an Internet-based research panel. One third of the women surveyed were African American. The focus on vulvar pain was not apparent until midway through the survey.

Half of the women surveyed had experienced dyspareunia at some point during their lifetime, 288 women (27.9%) reported pain at the vestibule, and 31 women (3%) reported pain lasting more than three months. Intensity of pain was rated as moderate or mild by most women in whom pain had resolved, and as severe by 80% of women who were currently experiencing prolonged pain.

"There's a spectrum of pain involved that's different in each woman," Dr. Reed says. "For some women, the pain is quite intense and debilitating — they know something is wrong. For other women, it's mild and they think it's supposed to hurt. As more women hear about this condition, they'll be coming out of the woodwork."

Contrary to popular belief that African-American women rarely have vulvodynia, dyspareunia and pain at the vulvar vestibule were as common in the African-American women as in the white women surveyed. Previous research showed that African-American women were less likely to seek treatment for vulvodynia from their physicians.

Other misconceptions about vulvodynia spring from lack of familarity of many physicians with vulvar pain disorders. Many women with intense pain may be misdiagnosed with chronic yeast infections or psychological conditions. Others may fail to report vulvar pain, believing that some degree of pain in this region is normal.

Pharmacologic treatment with gabapentin, amitriptyline, or paroxetine is often effective, and physical therapy may also be helpful. "Often the women I see have gone years with this pain, yet the majority of women see great relief with treatment," Dr. Reed says.

Future research may focus on why vulvodynia resolves in some women but remains chronic in others.

The University of Michigan Department of Family Medicine helped fund this study.

J Lower Genital Tract Dis. 2004;000:000-000

Reviewed by Gary D. Vogin, MD


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