Vulvar vestibulitis: a multi-factorial condition

To study differences in somatic symptoms and personality dimensions between women with vulvar vestibulitis and a non-symptomatic control group.

A case-control study conducted in 1998.

Two clinics in northern Sweden.

Thirty-eight women, 18-25 years of age, suffering from vulvar vestibulitis, and 70 healthy controls.

The women completed two questionnaires: the temperament and character inventory to study personality aspects, and the Giessen subjective complaints list, which is a checklist of subjective bodily complaints.

Regarding personality aspects the women with vulvar vestibulitis scored significantly higher than the control group, on exclusively one out of seven subscales of the temperament and character inventory (i.e. harm avoidance). This trait is considered to be partly inherited and stable throughout life, and to give the person a tendency to react to problems with pessimistic thoughts, increased anxiety and fatigue. On the Giessen subjective complaints list the women with vestibulitis reported a significantly higher number of somatic complaints in several areas.

The findings that women suffering from vulvar vestibulitis have more bodily complaints than the controls is interpreted as an indication of a psychosomatic element in their illness, which could be primary or secondary. 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 vestibulitis is advocated and a multimodal interdisciplinary treatment approach is suggested. To elucidate further the mechanisms behind this health problem, prospective controlled studies are urgently needed.