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A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia?
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2003
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Chronic unexplained vulvar pain is a highly prevalent disorder that is often misdiagnosed, with nearly 40 % of affected women not seeking treatment and many consulting multiple doctors without a diagnosis. The study aimed to estimate the prevalence of unexplained chronic vulvar pain in an ethnically diverse, population‑based sample of women. Researchers identified 4,915 women aged 18–64 from five Boston communities using census directories, administered a self‑completed questionnaire with a 68 % response rate, and calculated cumulative incidence and 95 % confidence intervals by demographic and reproductive characteristics. Approximately 16 % reported a history of chronic vulvar pain lasting at least three months, nearly 7 % were experiencing it at the time of the survey, prevalence was similar among white and African American women but 80 % higher among Hispanic women, and those with pain were 7–8 times more likely to report severe tampon‑use pain.
To estimate the prevalence of unexplained chronic vulvar pain (burning or sharp knife like pain or pain on contact) in an ethnically diverse population-based sample of women.We used town census directories to identify 4915 women age 18 to 64 from 5 ethnically diverse Boston communities and asked them to complete a self-administered questionnaire pertaining to current and past chronic lower genital tract discomfort (response rate 68%). We calculated the cumulative incidence and 95% confidence intervals by demographic and reproductive characteristics. Approximately 16% of respondents reported histories of chronic burning, knife like pain, or pain on contact that lasted for at least 3 months or longer, and nearly 7% were experiencing the problem at the time of the survey. Chronic vulvar pain on contact decreased with increasing age, but the cumulative incidence of chronic burning and knife like pain was similar across all ages. Contrary to earlier clinical assessments, white and African American women reported similar lifetime prevalences. However, Hispanic women were 80% more likely to experience chronic vulvar pain than were white and African American women. Women with histories of chronic vulvar pain were 7 to 8 times more likely to report difficulty and great pain with their first tampon use than were women without such histories. Nearly 40% of women chose not to seek treatment, and of those who did, 60% saw 3 or more doctors, many of whom could not provide a diagnosis.Chronic unexplained vulvar pain is a highly prevalent disorder that is often misdiagnosed.