Steroid receptor expression and morphology in provoked vestibulodynia.
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.
Johannesson
Ulrika
U
Division of Obstetrics and Gynecology, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden. ulrika.johannesson@ds.se
Sahlin
Lena
L
Masironi
Britt
B
Hilliges
Marita
M
Blomgren
Bo
B
Rylander
Eva
E
Bohm-Starke
Nina
N
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*
D011987:Receptors, Steroid