The Association Between Vulvodynia and Subsequent Morbidity Across the Life Course

Vulvodynia is chronic vulvar pain frequently associated with other comorbid chronic pain conditions. However, it is unclear whether women with vulvodynia experience higher rates of non-pain-related disorders after first onset of vulvar pain relative to unexposed women.

Women born in Sweden between 1981 and 1996 were identified from Sweden's Medical Birth Register (N=832,276) and assigned "exposed" if diagnosed with localized provoked vulvodynia (n=4,787), vaginismus (n=2,063), or both (n=867) between 2001 and 2018. Two women with no vulvar pain were matched to women with vulvar pain by birth year and assigned a reference year aligned with women's vulvar pain diagnosis. We assessed the cumulative incidence of new-onset conditions 1 year or later after vulvodynia diagnosis and comparable time periods among unexposed women. We further assessed the risk difference among all new-onset global ICD-10-recorded diagnostic codes, and risk difference, relative risks, and attributable fraction among highly observed new-onset ICD-10 codes.

Among all ICD-10-coded global categories, we observed 4 to 5 more new-onset infectious disease codes (95% CI: 3.7-5.3) per 100 women, and 3 to 4 more new-onset global mental health (95% CI: 3.0-4.5), genital tract (2.6-4.5), and skin condition (95% CI: 2.7-4.2) codes per 100 women exposed to vulvar pain relative to those unexposed. New-onset conditions with the largest relative risks and attributable fractions included candidiasis, STDS, mood/anxiety disorders, dermatitis, and irregular menstruation.

Women with vulvodynia may have a compromised immune system that increases the risk of a wide spectrum of other health-related conditions after a vulvodynia diagnosis.