Vaginal microbiological flora, and behavioural and clinical findings in women with vulvar pain

Objective To study genital symptoms and signs in women with vulvar pain, an d the association with potential risk factors such as microbiological agent s, sexual behaviour and genital hygiene. Design Prospective cohort study of apparently healthy women attending for c ontraceptive advice. Setting Two family planning clinics and one youth clinic in Sweden. Population Out of 996 women recruited, 79 women (7.9%) had, on request, com plaints of current burning and smarting vulvar pain and/or superficial dysp areunia (our definition of vulvar pain) while 917 women without such sympto ms served as controls. Results Complaints of dysmenorrhoea, vaginal discharge, genito-anal pruritu s, dysuria, and abdominal pain were more frequent in the study group, than in the control group. In the women with vulvar pain, erythemas: superficial ulcerations, and fissures were found significantly more frequently. Vagina l candidosis was the only current genital infection that occurred more ofte n in the study group, than among the controls. There: were no differences i n the history of gonorrhoea, genital chlamydial infection, genital herpes, genital warts, and candidosis between the two groups. The sexual debut of t he women with vulvar pain occurred later in life, compared with the control group. Control subjects were more likely to use tampons for menstrual sani tation: than the women with vulvar pain. Conclusions Neither infectious conditions caused by current known agents, w ith the exception of candidosis in some cases, nor behavioural factors, suc h as sexual behaviour and genital hygiene habits could in this study explai n vulvar pain.