Several hypotheses have been proposed to identify etiological factors for vulvodynia. A high concentration of calcium oxalate crystals in the urine (27), allergies (28), hormonal relationships (29), history of abuse (30), genetics (25), psychological conditions (11), and recurrent infections (e.g., Candidiasis/ yeast, human papilloma virus, and bacterial vaginosis) (20,31,32) have been thought to play a role in disease development. Yet, there is no agreement in the literature regarding these and other theories. Moreover, these issues have been described primarily in small, uncontrolled studies, and there is a lack of systematic, large-scale studies that explore them in greater depth (33).

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