Vulvodynia: Etiology, therapeutic options and impact on quality of life

Anu Aalto

Research output: Book/ReportDoctoral thesisCollection of Articles

Abstract

Vulvodynia, a chronic genital and pelvic pain condition, affects approximately 8% of women. Localized provoked vulvodynia (LPV) is the most common subtype of the condition especially among young women. The etiology of LPV is unknown, although inflammation may play a role. The efficacy of most vulvodynia treatments has not been proven in a randomized, controlled study setting.

The aim of the study was to collect and analyze retrospective data on all women diagnosed and treated for vulvodynia at Tampere University Hospital (TAUH) in 2003–2013. Among the 133 patients, symptom correlation with demographic variables, the efficacy of treatments after follow-up, and the patients’ satisfaction with treatments and different professionals were analyzed. Also, a subgroup of vulvodynia patients treated surgically at TAUH in 2003–2016 was identified. Efficacy and quality of life (QoL) were compared between the surgical and non-surgical treatment protocols. In order to evaluate the etiology of LPV the patients’ vestibulectomy samples (n=12) were analyzed by immunohistochemistry and compared to the vulvar samples from healthy controls (n=15). Different subtypes of estrogen-related receptors (ERRs), estrogen receptor (ER), progesterone receptor (PR) and inflammatory T-cells (CD3) were analyzed. Finally, the microbiomes of patients suffering from LPV (n=30) with those in healthy controls (n=20), using swabs collected prospectively from the vulvar vestibulum.

To summarize, combining different treatment modalities, and age under 30 years predicted better outcome in terms of pain control in vulvodynia patients. Short-term QoL was better and self-reported pain was lower after surgical treatment. However, this benefit was not maintained after a follow-up period of three years. Furthermore, LPV patients showed differential vulvar expression of ERRß as well as dissimilarities in the vulvar microbiome when compared with controls, suggesting possible hormonal and inflammation-related factors in the etiology of LPV.
Original languageEnglish
Place of PublicationTampere
PublisherTampere University
ISBN (Electronic)978-952-03-1625-9
ISBN (Print)978-952-03-1624-2
Publication statusPublished - 2020
Publication typeG5 Doctoral dissertation (article)

Publication series

NameTampere University Dissertations - Tampereen yliopiston väitöskirjat
Volume278
ISSN (Print)2489-9860
ISSN (Electronic)2490-0028

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