(227) Differences in phenotype between Hispanic and non-Hispanic White women with chronic vulvar pain

Abstract

Hispanic women have significantly higher prevalence of chronic vulvar pain compared to non-Hispanic Whites, a finding consistently shown across population-based studies. However, chronic vulvar pain is known to have heterogeneous phenotypes, and it is not known whether Hispanic women more often present with phenotypes different from that of non-Hispanic Whites. Improved understanding of phenotypes may elucidate underlying biopsychosocial mechanisms, and allow for targeted therapies. Therefore, we examined symptoms consistent with particular phenotypes to determine whether they differed among Hispanic versus non-Hispanic White women. Data were from a population-based cross-sectional study of 29,582 women in Minneapolis/St. Paul between 2010 - 2013 who returned a mailed screener inquiring about the presence and description of vulvar pain. Surveys were available in Spanish and English. Overall in this population, ∼8% of respondents exhibited chronic vulvar pain consistent with a vulvodynia diagnosis, and Hispanics are 40% more likely to have chronic vulvar pain than non-Hispanic Whites. In this analysis we found that Hispanics were more likely (adj. risk ratio=1.40, p<0.01) to report primary vulvodynia, defined as pain with first intercourse or tampon use, after accounting for age at menarche, vulvar pain duration, and the number of chronic overlapping pain conditions (COPC). However, Hispanics were 16% more likely to report that their pain can be alleviated with some type of behavior or remedy (p=0.04); among the subgroup with vulvar pain who used yeast cream, Hispanics more often reported benefit of some degree (adj. risk ratio=1.49, p<0.01). No differences between the two ethnicities were found for provoked versus unprovoked, generalized versus localized, or intermittent versus continuous vulvar pain phenotypes. Hispanics were 52% more likely (p=0.02) than non-Hispanic Whites to describe a burning pain. Our findings suggest that the difference in the rates of primary vulvodynia may, in part, explain the differences in prevalence between Hispanic and non-Hispanic women. Hispanic women have significantly higher prevalence of chronic vulvar pain compared to non-Hispanic Whites, a finding consistently shown across population-based studies. However, chronic vulvar pain is known to have heterogeneous phenotypes, and it is not known whether Hispanic women more often present with phenotypes different from that of non-Hispanic Whites. Improved understanding of phenotypes may elucidate underlying biopsychosocial mechanisms, and allow for targeted therapies. Therefore, we examined symptoms consistent with particular phenotypes to determine whether they differed among Hispanic versus non-Hispanic White women. Data were from a population-based cross-sectional study of 29,582 women in Minneapolis/St. Paul between 2010 - 2013 who returned a mailed screener inquiring about the presence and description of vulvar pain. Surveys were available in Spanish and English. Overall in this population, ∼8% of respondents exhibited chronic vulvar pain consistent with a vulvodynia diagnosis, and Hispanics are 40% more likely to have chronic vulvar pain than non-Hispanic Whites. In this analysis we found that Hispanics were more likely (adj. risk ratio=1.40, p<0.01) to report primary vulvodynia, defined as pain with first intercourse or tampon use, after accounting for age at menarche, vulvar pain duration, and the number of chronic overlapping pain conditions (COPC). However, Hispanics were 16% more likely to report that their pain can be alleviated with some type of behavior or remedy (p=0.04); among the subgroup with vulvar pain who used yeast cream, Hispanics more often reported benefit of some degree (adj. risk ratio=1.49, p<0.01). No differences between the two ethnicities were found for provoked versus unprovoked, generalized versus localized, or intermittent versus continuous vulvar pain phenotypes. Hispanics were 52% more likely (p=0.02) than non-Hispanic Whites to describe a burning pain. Our findings suggest that the difference in the rates of primary vulvodynia may, in part, explain the differences in prevalence between Hispanic and non-Hispanic women.