Relationship between vulvodynia and chronic comorbid pain conditions

OBJECTIVE: To estimate the relationship among the presence of vulvodynia, fibromyalgia, interstitial cystitis, and irritable bowel syndrome. METHODS: Validated questionnaire-based screening tests for the four pain conditions were completed by women with and without vulvodynia who were participating in the Michigan Woman to Woman Health Study, a longitudinal population-based survey in southeastern Michigan. Weighted population-based estimates of the prevalence and characteristics of participants with these chronic comorbid pain conditions were calculated using regression analyses. RESULTS: Of 1,940 women who completed the survey containing all four screening tests, 1,890 (97.4%) answered all screening questions and were included. The prevalences of the screening-based diagnoses ranged from 7.5% (95% confidence interval [CI] 6.2-9.0) for interstitial cystitis, 8.7% (95% CI 7.3-10.4) for vulvodynia, 9.4% (95% CI 8.1-11.0) for irritable bowel syndrome, to 11.8% (95% CI 10.1-13.7) for fibromyalgia with 27.1% screening positive for multiple conditions. The presence of vulvodynia was associated with the presence of each of the other comorbid pain conditions (P<.001, odds ratio 2.3-3.3). Demographic risk factors for each condition varied. Increasing age was not associated with greater numbers of comorbid conditions, and only low socioeconomic status was associated with having multiple comorbid conditions concurrently. CONCLUSION: Chronic pain conditions are common, and a subgroup of women with vulvodynia is more likely than those without vulvodynia to have one or more of the three other chronic pain conditions evaluated.