Decreased mechanical pain threshold in the vestibular mucosa of women using oral contraceptives: a contributing factor in vulvar vestibulitis?
OBJECTIVE
To analyze possible differences in somatosensory perception in the vestibular mucosa in healthy women associated with the use of oral contraceptives.


METHODS
Quantitative sensory tests were performed on the vestibular mucosa in 39 healthy women. Twenty women were using oral contraceptives containing 30-40 microg ethinyl estradiol combined with various progestins; 19 women with regular menstrual periods not using oral contraceptives served as controls. The testing included mechanical and heat pain thresholds and detection thresholds of warmth and cold in the anterior and posterior part of the vestibule.


RESULTS
Significant lower mechanical pain thresholds were observed in both areas tested in women using oral contraceptives. The most sensitive area was the posterior vestibule in the group using oral contraceptives with a mechanical pain threshold of 72 +/- 10 ( +/-SEM) mN as compared to 161 +/- 3 mN (p < 0.01), in the controls. The result of the thermotest showed no significant differences between the groups.


CONCLUSIONS
Oral contraceptives may induce increased sensitivity in the vestibular mucosa in healthy women and might be one contributingfactor in the development of vulvar vestibulitis.
Bohm-Starke
Nina
N
Division of Obstetrics and Gynaecology, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden. nina.bohm-starke@ds.se
Johannesson
Ulrika
U
Hilliges
Marita
M
Rylander
Eva
E
Torebjörk
Erik
E
D000328:Adult; D003276:Contraceptives, Oral / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009092:Mucous Membrane; D010146:Pain / Q000209:etiology* / Q000473:pathology; D017288:Pain Threshold; D012307:Risk Factors; D014845:Vulvar Diseases / Q000209:etiology* / Q000473:pathology
D003276:Contraceptives, Oral