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Exploring Hygienic Behaviors and Vulvodynia

Klann, Alexandra M. MPH1; Rosenberg, Jessica MPH1; Wang, Tanran MPH1; Parker, Samantha E. PhD1; Harlow, Bernard L. PhD1,2

Journal of Lower Genital Tract Disease: July 2019 - Volume 23 - Issue 3 - p 220–225
doi: 10.1097/LGT.0000000000000477
Original Research Articles: Vulva and Vagina

Objectives Vulvodynia is common and characterized by vulvar discomfort and pain. However, few studies have assessed hygienic practices in relation to onset. We investigated whether hygienic behaviors were associated with the onset of vulvodynia.

Materials and Methods We assessed a self-reported history of personal hygienic behaviors, including wearing tight-fitting clothing, vulva care and genital washing, pubic hair removal, douching, and powdering, a year before first reported onset of vulvar pain among 213 clinically confirmed cases and a similar time period among 221 general population controls.

Results Compared with women who reported never wearing tight-fitting jeans or pants, women wearing tight-fitting jeans or pants 4 or more times per week had twice the odds of vulvodynia (95% CI = 1.14–3.95). Relative to controls, women with vulvodynia were substantially less likely to report use of soaps and gels to cleanse the vulva (95% CI = 0.17–0.63). Among women who chose to remove pubic hair, those who removed pubic hair from the mons pubis compared with bikini-area only hair removal, were 74% more likely to have vulvodynia (95% CI = 1.05–2.89). Finally, compared with women who reported bikini-area only hair removal less than monthly, those who removed hair from the mons pubis weekly or more were nearly 2 times more likely to be vulvodynia cases (95% CI = 0.83–3.49).

Conclusions Wearing tight-fitting jeans or pants and removing hair from the mons pubis area were associated with increased odds of vulvodynia. Research on how hygienic practices could influence vulvar pain in larger and more temporally addressed populations is warranted.

1Boston University School of Public Health, Boston, MA; and

2Division of Epidemiology & Community Health, School of Public Health University of Minnesota, Minneapolis, MN

Reprint requests to: Bernard L. Harlow, PhD, Department of Epidemiology, Boston University School of Public Health, 715 Albany St, T424E, Boston, MA 02118. E-mail:

The authors have declared they have no conflicts of interest.

A.M.K., J.R., and T.W. contributed equally to this study and the preparation of the article.

This study was supported by NIH-NICHD R01 HD058608.

This study was approved by the Human Subjects Review Committees at both the University of Minnesota and Boston University.

Online date: April 10, 2019

Copyright © 2019 by the American Society for Colposcopy and Cervical Pathology