Prevalence And Patient Demographics

The prevalence of VVS in the general population is unknown. The prevalence of women diagnosed with VVS was 20% over a four-year period among the cohort of women presenting to a referral center for vulvovaginal disorders (11), 15% among patients seen over a six-month period in a gynecology clinic (12), and 1.3% among 24 walk-in patients in a genitourinary clinic (13). Patients ranged in age from 20 to 40 and were predominantly Caucasian. Case-control studies from North America suggest that VVS is more common in white women of reproductive age than in African American women (14). A global web-based survey initiated by highly educated, internet-savvy women with complaints of vulvar pain found that 90% of the 428 respondents were Caucasian women of reproductive age (15). The reported prevalence of VVS and dysesthetic vulvody-nia in this survey was 55% and 43%, respectively; however, the reported diagnoses lacked independent confirmation and more than one diagnosis could be chosen by respondents.

Available demographic statistics may be skewed by cultural differences in the likelihood of seeking intervention as well as by diagnostic delays. The only available population-based survey, which comprised 4915 women aged 18 to 64 from ethnically diverse communities in the Boston, Massachusetts (U.S.) area, found that 40% of women with vulvar pain sought no treatment, while 60% of those who did so consulted three or more health-care providers over several years before obtaining a diagnosis (16). About 16% of respondents reported histories of chronic burning or knife-like vulvar pain or pain on vulvar contact experienced over a period of at least three months; 12.4% complained specifically of pain on vulvar contact (16). Caucasian and African American women reported a similar lifetime prevalence but Latino women were 80% more likely to have experienced vulvar pain than the other two groups. Women with a history of vulvar pain were almost eight times more likely to have experienced difficulty or pain with first tampon use (16,17). The survey suggests that vulvar pain syndromes are more widespread among various ethnic groups than previously thought, but does not fully distinguish between women whose pain is elicited by vestibular contact VVS and those who have chronic or unremitting vulvar pain in the absence of stimulation (dysesthetic vulvodynia).

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