title: Steroid receptor expression and morphology in provoked vestibulodynia.
abstract: OBJECTIVE
  This study was undertaken to survey the steroid receptor expression and morphology in the vulvar vestibular mucosa in women with provoked vestibulodynia.
  
  
  METHODS
  Fourteen patients and 25 controls without oral contraceptives were included. Vestibular biopsy specimens were obtained and analyzed by using immunohistochemistry, followed by computerized image analysis of estrogen receptors alpha and beta, progesterone receptors A and B, glucocorticoid receptor, androgen receptor, and the proliferation marker Ki67. The morphology was estimated by measuring 4 parameters in the epithelium.
  
  
  RESULTS
  There was a significantly higher expression of estrogen receptor alpha in both the epithelium (P = .04) and the stroma (P = .02) in the patient specimens compared with the controls. There were no significant differences in the other analyses performed.
  
  
  CONCLUSIONS
  There is an increased expression of estrogen receptor alpha in the vestibular mucosa but the epithelial morphology seems unaffected in women with provoked vestibulodynia. Further studies regarding plausible associations to neurogenic inflammation are needed.
authors.affiliation: Division of Obstetrics and Gynecology, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. ulrika.johannesson@ds.se
authors.forename: Ulrika
authors.initials: U
authors.lastname: Johannesson
authors.forename: Lena
authors.initials: L
authors.lastname: Sahlin
authors.forename: Britt
authors.initials: B
authors.lastname: Masironi
authors.forename: Marita
authors.initials: M
authors.lastname: Hilliges
authors.forename: Bo
authors.initials: B
authors.lastname: Blomgren
authors.forename: Eva
authors.initials: E
authors.lastname: Rylander
authors.forename: Nina
authors.initials: N
authors.lastname: Bohm-Starke
mesh_terms: D000328:Adult; D004414:Dyspareunia / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D009092:Mucous Membrane / Q000378:metabolism; D011987:Receptors, Steroid / Q000096:biosynthesis*; D014844:Vulva / Q000378:metabolism* / Q000473:pathology*
chemical_list: D011987:Receptors, Steroid