Journal of lower genital tract disease · 2026
The Association Between Vulvodynia and Subsequent Morbidity Across the Life Course.
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Harlow Bernard L, Yan Jane, Mühlrad Hanna, Lu Donghao, Bohm-Starke Nina
Аннотация
OBJECTIVE: Vulvodynia is chronic vulvar pain frequently associated with other comorbid chronic pain conditions. However, it is unclear whether women with vulvodynia experience higher rates of non-pain-related disorders after first onset of vulvar pain relative to unexposed women.
METHODS: Women born in Sweden between 1981 and 1996 were identified from Sweden's Medical Birth Register (N=832,276) and assigned "exposed" if diagnosed with localized provoked vulvodynia (n=4,787), vaginismus (n=2,063), or both (n=867) between 2001 and 2018. Two women with no vulvar pain were matched to women with vulvar pain by birth year and assigned a reference year aligned with women's vulvar pain diagnosis. We assessed the cumulative incidence of new-onset conditions 1 year or later after vulvodynia diagnosis and comparable time periods among unexposed women. We further assessed the risk difference among all new-onset global ICD-10-recorded diagnostic codes, and risk difference, relative risks, and attributable fraction among highly observed new-onset ICD-10 codes.
RESULTS: Among all ICD-10-coded global categories, we observed 4 to 5 more new-onset infectious disease codes (95% CI: 3.7-5.3) per 100 women, and 3 to 4 more new-onset global mental health (95% CI: 3.0-4.5), genital tract (2.6-4.5), and skin condition (95% CI: 2.7-4.2) codes per 100 women exposed to vulvar pain relative to those unexposed. New-onset conditions with the largest relative risks and attributable fractions included candidiasis, STDS, mood/anxiety disorders, dermatitis, and irregular menstruation.
CONCLUSIONS: Women with vulvodynia may have a compromised immune system that increases the risk of a wide spectrum of other health-related conditions after a vulvodynia diagnosis.
METHODS: Women born in Sweden between 1981 and 1996 were identified from Sweden's Medical Birth Register (N=832,276) and assigned "exposed" if diagnosed with localized provoked vulvodynia (n=4,787), vaginismus (n=2,063), or both (n=867) between 2001 and 2018. Two women with no vulvar pain were matched to women with vulvar pain by birth year and assigned a reference year aligned with women's vulvar pain diagnosis. We assessed the cumulative incidence of new-onset conditions 1 year or later after vulvodynia diagnosis and comparable time periods among unexposed women. We further assessed the risk difference among all new-onset global ICD-10-recorded diagnostic codes, and risk difference, relative risks, and attributable fraction among highly observed new-onset ICD-10 codes.
RESULTS: Among all ICD-10-coded global categories, we observed 4 to 5 more new-onset infectious disease codes (95% CI: 3.7-5.3) per 100 women, and 3 to 4 more new-onset global mental health (95% CI: 3.0-4.5), genital tract (2.6-4.5), and skin condition (95% CI: 2.7-4.2) codes per 100 women exposed to vulvar pain relative to those unexposed. New-onset conditions with the largest relative risks and attributable fractions included candidiasis, STDS, mood/anxiety disorders, dermatitis, and irregular menstruation.
CONCLUSIONS: Women with vulvodynia may have a compromised immune system that increases the risk of a wide spectrum of other health-related conditions after a vulvodynia diagnosis.