Highlights
- •Vulvodynia may be due to immune dysregulation given its association with other immune conditions.
- •The risk of vulvodynia is greater with increasing numbers of unique immune related conditions.
- •Being born preterm, small for gestational age, or low birth weight may increase vulvodynia risk.
Abstract
Vulvodynia, impacts up to 8% of women by age 40, and is hypothesized to manifest through
an altered immune-inflammatory response. To test this hypothesis, we identified all
women born in Sweden between 1973 and 1996 diagnosed with localized provoked vulvodynia
(N76.3) and/or vaginismus (N94.2 or F52.5) between 2001 and 2018. We matched each
case to two women from the same birth year with no vulvar pain ICD codes. As a proxy
for immune dysfunction, we used Swedish Registry data to capture 1) immunodeficiencies,
2) single organ and multiorgan autoimmune conditions, 3) allergy and atopies, and
4) malignancies involving immune cells across the life course. Women with vulvodynia,
vaginismus or both were more likely to experience immune deficiencies (OR 1.8, 95%
CI, 1.2–2.8), single organ (OR 1.4, 95% CI, 1.2–1.6) and/or multi-organ (OR 1.6, 95%
CI, 1.3–1.9) immune disorders, and allergy/atopy conditions (OR 1.7, 95% CI, 1.6–1.8)
compared to controls. We observed greater risk with increasing numbers of unique immune
related conditions (1 code: OR = 1.6, 95% CI, 1.5–1.7; 2 codes: OR = 2.4, 95% CI,
2.1–2.9; 3 or more codes: OR = 2.9, 1.6–5.4). These findings suggest that women with
vulvodynia may have a more compromised immune system either at birth or at points
across the life course than women with no vulvar pain history.
Perspective
Women with vulvodynia are substantially more likely to experience a spectrum of immune
related conditions across the life course. These findings lend support to the hypothesis
that chronic inflammation initiates the hyperinnervation that causes the debilitating
pain in women with vulvodynia.
Key words
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Article info
Publication history
Published online: March 18, 2023
Accepted:
March 11,
2023
Received in revised form:
March 7,
2023
Received:
November 8,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
All authors declare no conflicts of interest.
The research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Grant R21-HD099533.
Identification
Copyright
© 2023 by United States Association for the Study of Pain, Inc.
