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 1973-1996 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 a) immunodeficiencies,
b) single organ and multiorgan autoimmune conditions, c) allergy and atopies, and
d) 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.
Keywords
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Article info
Publication history
Accepted:
March 11,
2023
Received in revised form:
March 7,
2023
Received:
November 8,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© Published by Elsevier Inc. on behalf of United States Association for the Study of Pain, Inc.
