Past studies focused largely on the relationship between vulvar symptoms and gynecologic history. Although the preliminary findings of Harlow et al. (17) suggested that women who began menstruating at the age of 11 or younger are 2.4 times as likely to report chronic vulvar pain. The later work of Harlow and Stewart (16) suggested there is no risk associated with age at menarche. Pain and/or difficulty with first tampon use is associated with seven-fold greater odds of chronic vulvar pain (16). Women with vulvodynia are also 6.6 times as likely to have used oral contraceptives, an association that increases to 9.3 if oral contraceptive use began before the age of 16 (18).
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