Epidemiology of vulvar vestibulitis syndrome: an exploratory case-control study

Background: Vulvar vestibulitis syndrome (WS) is a chronic, persistent synd rome characterised by vestibular pain, tenderness, and erythema. The aetiol ogy of WS is unknown and few of the hypothesised risk factors have been tes ted in controlled studies. Methods: Using a matched case-control study design, medical, sexual, health behaviour, and diet history of 28 women with WS were compared with 50 frie nd controls without WS to identify possible causal factors. Results: Cases were more likely than controls to report every vaginal and u rinary symptom at the time of interview measured, particularly vaginal sore ness or pain (60.7%) and pain during intercourse (64.3%). There were no sig nificant differences between cases and controls with respect to sexual beha viour. Cases were more likely than controls to report self reported history of physician diagnosed bacterial vaginosis (OR=22.2, 95%CI=2.8, 177.2, p v alue=0.0001), vaginal yeast infections (OR=4.9, 95%CI=1.4, 18.0, p value=0. 01), and human papillomavirus (OR=7.1, 95%CI=0.6, 81.2, p value=0.08). Ther e were no differences between cases and controls with respect to dietary in take of oxalate. Cases were more likely than controls to report poor health status (OR=5.7, 95%CI=1.1, 28.7, p value=0.02) and history of depression f or 2 weeks or more during the past year (OR=4.4, 95%CI=1.6, 12.3, p value=0 .002). Conclusion: Self reported history of bacterial vaginosis, yeast infections, and human papillomavirus were strongly associated with WS, An infectious o rigin for WS should be pursued in larger controlled studies, using question naire and laboratory measures.