Vulvar vestibulitis: a multi-factorial condition

Objective To study differences in somatic symptoms and personality dimensio ns between women with vulvar vestibulitis and a non-symptomatic control gro up. Design A case-control study conducted in 1998. Setting Two clinics in northern Sweden. Sample Thirty-eight women, 18-25 years of age, suffering from vulvar vestib ulitis, and 70 healthy controls. Methods The women completed two questionnaires: the temperament and charact er inventory to study personality aspects, and the Giessen subjective compl aints list, which is a checklist of subjective bodily complaints. Results Regarding personality aspects the women with vulvar vestibulitis sc ored significantly higher than the control group, on exclusively one out of seven subscales of the temperament and character inventory (i.e. harm avoi dance). This trait is considered to be partly inherited and stable througho ut life, and to give the person a tendency to react to problems with pessim istic thoughts, increased anxiety and fatigue. On the Giessen subjective co mplaints list the women with vestibulitis reported a significantly higher n umber of somatic complaints in several areas. Conclusions The findings that women suffering from vulvar vestibulitis have more bodily complaints than the controls is interpreted as an indication o f a psychosomatic element in their illness. which could be primary or secon dary Furthermore these women are characterised by a particular personality trait, and it is suggested that this trait might influence their experience and management of pain and stress. A multi-factorial origin of vulvar vest ibulitis is advocated and a multimodal interdisciplinary treatment approach is suggested. To elucidate further the mechanisms behind this health probl em, prospective controlled studies are urgently needed.