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Relationship Between Vulvodynia and Chronic Comorbid Pain Conditions

Reed, Barbara D. MD, MSPH; Harlow, Siobán D. PhD; Sen, Ananda PhD; Edwards, Rayna M. MPH; Chen, Di MPH; Haefner, Hope K. MD

doi: 10.1097/AOG.0b013e31825957cf
Original Research

OBJECTIVE: To estimate the relationship among the presence of vulvodynia, fibromyalgia, interstitial cystitis, and irritable bowel syndrome.

METHODS: Validated questionnaire-based screening tests for the four pain conditions were completed by women with and without vulvodynia who were participating in the Michigan Woman to Woman Health Study, a longitudinal population-based survey in southeastern Michigan. Weighted population-based estimates of the prevalence and characteristics of participants with these chronic comorbid pain conditions were calculated using regression analyses.

RESULTS: Of 1,940 women who completed the survey containing all four screening tests, 1,890 (97.4%) answered all screening questions and were included. The prevalences of the screening-based diagnoses ranged from 7.5% (95% confidence interval [CI] 6.2–9.0) for interstitial cystitis, 8.7% (95% CI 7.3–10.4) for vulvodynia, 9.4% (95% CI 8.1–11.0) for irritable bowel syndrome, to 11.8% (95% CI 10.1–13.7) for fibromyalgia with 27.1% screening positive for multiple conditions. The presence of vulvodynia was associated with the presence of each of the other comorbid pain conditions (P<.001, odds ratio 2.3–3.3). Demographic risk factors for each condition varied. Increasing age was not associated with greater numbers of comorbid conditions, and only low socioeconomic status was associated with having multiple comorbid conditions concurrently.

CONCLUSION: Chronic pain conditions are common, and a subgroup of women with vulvodynia is more likely than those without vulvodynia to have one or more of the three other chronic pain conditions evaluated.

LEVEL OF EVIDENCE: II

Subgroups of women with vulvodynia are more likely than those without this disorder to have one or more of three other chronic comorbid pain conditions.

From the Departments of Family Medicine, Biostatistics, and Obstetrics and Gynecology and the School of Public Health, University of Michigan, Ann Arbor, Michigan.

Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, The National Institutes of Health, R01 HD 054767.

The authors thank Laurie Legocki, PhD, and Susan Countryman for project management; Jill Bowdler for assistance with participant correspondence and secretarial support; and Margaret Helmuth for data management. Salary support for these individuals was provided by grant National Institutes of Health R01 HD 054767 (Susan Countryman and Margaret Helmuth) and by the Department of Family Medicine at the University of Michigan (Jill Bowdler).

Corresponding author: Barbara D. Reed, MD, MSPH, Department of Family Medicine, University of Michigan, 1018 Fuller Street, Ann Arbor, MI 48104-1213; e-mail: barbr@umich.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2012 The American College of Obstetricians and Gynecologists