Oral contraceptive use and risk of vulvodynia: a population-based longitudinal study.
OBJECTIVE
To assess whether the risk of vulvodynia is associated with previous use of oral contraceptives (OCs).


METHODS
Longitudinal population-based study.


METHODS
Four counties in south-east Michigan, USA.


METHODS
A population-based sample of women, aged 18 years and older, enrolled using random-digit dialling.


METHODS
Enrolled women completed surveys that included information on demographic characteristics, health status, current symptoms, past and present OC use, and a validated screen for vulvodynia. The temporal relationship between OC use and subsequent symptoms of vulvodynia was assessed using Cox regression, with OC exposure modelled as a time-varying covariate.


METHODS
Vulvodynia, as determined by validated screen.


RESULTS
Women aged <50 years who provided data on OC use, completed all questions required for the vulvodynia screen, and had first sexual intercourse prior to the onset of vulvodynia symptoms were eligible (n = 906). Of these, 71.2% (n = 645) had used OCs. The vulvodynia screen was positive in 8.2% (n = 74) for current vulvodynia and in 20.8% (n = 188) for past vulvodynia. Although crude cross-tabulation suggested that women with current or past vulvodynia were less likely to have been exposed to OCs prior to the onset of pain (60.7%), compared with those without this disorder (69.3%), the Cox regression analysis identified no association between vulvodynia and previous OC use (HR 1.08, 95% CI 0.81-1.43, P = 0.60). This null finding persisted after controlling for ethnicity, marital status, educational level, duration of use, and age at first OC use.


CONCLUSIONS
For women aged <50 years of age, OC use did not increase the risk of subsequent vulvodynia.
Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA.
B D
BD
Reed
S D
SD
Harlow
L J
LJ
Legocki
M E
ME
Helmuth
H K
HK
Haefner
B W
BW
Gillespie
A
A
Sen
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008824:Michigan; D008875:Middle Aged; D016016:Proportional Hazards Models; D012044:Regression Analysis; D018570:Risk Assessment; D056650:Vulvodynia / Q000453:epidemiology*; D055815:Young Adult
D003278:Contraceptives, Oral, Hormonal
Chronic pain; oral contraceptives; population-based; risk factors; vulvodynia