Prevalence

It is estimated that as many as 200,000 women in the United States suffer from vulvodynia (13) and that up to 14 million U.S. women will experience chronic vulvar pain symptoms in their lifetime, 30% of whom will choose not to consult a clinician (16). Yet these numbers are only estimates, limited by a lack of population-based studies. The true extent of disease is unknown (Fig. 1; Ref. 34).

A national Gallup survey estimated that chronic gynecologic pain of at least six months' duration affects approximately 15% of U.S. women. While endometriosis, pelvic inflammatory disease, and yeast infections accounted for some of this pain, the majority of women surveyed had never received a diagnosis for their symptoms (35). A British health study reported that 13.3% (n = 20) of genitourinary clinic patients suffered from vulvar pain, but 75% of these cases were the result of an infectious agent (36). While these studies underscore the magnitude of general gynecologic and vulvar pain, they are not specific to vulvodynia and do not afford prevalence estimates in the general population.

In 1991, Goetsch reported that 15% (n = 31) of women screened in a gynecologic practice met diagnostic criteria for vulvar vestibulitis (25). However, these findings cannot be extrapolated to the general population, which includes women who do not seek care for their symptoms. Until recently, Goetsch had published the only prevalence data in the literature. In 2001, Harlow and colleagues performed the first population-based study to assess the prevalence of chronic vulvar pain and found that 18.5% (n = 56) of 303 women surveyed randomly in a Boston, Massachusetts community indicated a minimum three-month history of genital tract discomfort at some point in their life; 8.6% of the total population had symptoms at the time of the survey (17). A second Boston study found that of the 3,358 eligible women surveyed, 16% reported a lifetime history of burning, knife-like chronic vulvar pain of at least three months in duration, and 7% of participants experienced symptoms at the time of the study (16).

H ¡story of Pelvic pain Current Past vulvar short-term vulvar pain pain vulvar pain

Figure 1 Prevalence of vulvodynia. Source: From Ref. 34.

H ¡story of Pelvic pain Current Past vulvar short-term vulvar pain pain vulvar pain

Figure 1 Prevalence of vulvodynia. Source: From Ref. 34.

Expanding on the work of Harlow et al., Reed (2) conducted a web-based survey with a national sample of 1,032 women and found a 27.9% lifetime prevalence of vestibular pain, with a 3% prevalence of symptoms lasting three months or longer. These two studies are important because, unlike earlier reports that focused on women seen in gynecological care settings, they were based on the general population. Yet, Reed's (2) national web-based survey yielded only a 23% response rate and, thus, additional studies with higher response rates are required to further explore prevalence and characteristics of vulvar pain at the national level.

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