Assessment of vulvodynia symptoms in a sample of U.S. women: a follow-up national incidence survey.

OBJECTIVE To estimate the annual incidence of vulvodynia-like symptoms and evaluate triggers of vulvar pain in a sample of U.S. women. METHODS After a 1-year interval, women who previously participated in a national vulvodynia prevalence study were recontacted and administered a telephone questionnaire that assessed self-reported vulvodynia-like symptoms and triggers of symptoms. RESULTS From the original cohort of 425 women, 285 (67%) participated in this follow-up study. Symptoms consistent with vulvodynia occurring within 1 year of initial contact were reported by 4.7% of previously asymptomatic women. Nearly 50% of the original patients again reported a history of vulvodynia-like symptoms, with 68.6% of these as persistent over the past year. Of significance, pain or discomfort with first-time tampon use was 2.15 times more likely (95% CI 1.0-4.62) in symptomatic women. These women were also 2.4 times more likely (95% CI 1.29-4.53) to use a combination of tampons and pads for sanitary protection rather than one method alone. CONCLUSIONS Over the course of 1 year, as many as 1 in 20 women may experience new-onset chronic genital pain. Despite a higher likelihood of having discomfort or pain with first tampon use, symptomatic women did not exhibit a preference for sanitary napkins. This indicates that lack of tampon use because of pain may not be an effective screening criterion for vulvodynia. We recommend additional studies with symptomatic and diagnosed women to explore in more detail the issues surrounding tampon use history and chronic genital pain.