Vulvodynia prevalence and associated psychosexual problems in middle-aged diabetics at a tertiary care hospital in Pakistan

Background & Objective: Vulvodynia is a significant clinical disorder in women but it remains a neglected health problem in many societies. The present study was aimed to identify the frequency of vulvodynia in the diabetic and non-diabetic population and its association with common psychosexual problems in the population of Khyber Pakhtunkhwa, Pakistan. Methods: This study is cross sectional descriptive investigation and conducted in tertiary care hospital (Lady Reading Hospital, Peshawar) in 2018-2019. A total of 75 cases categorized into diabetic and non-diabetic groups were collected under the supervision of qualified gynecologists. Groups were compared on the basis of demographics, symptom frequency, psychological and clinical data, using a pre-designed proforma. Results: The incidence of vulvodynia in women with type 1 and type 2 diabetes (n = 50) and in the non-diabetic population (n = 25) was 66.6% and 33.3%, respectively. The vulvodynia severity score based on Friedrich`s criteria in diabetes was 80% and in non-diabetes it was 40%. The cotton bud swab test severity index was 80% in diabetes and 40% in non-diabetes. The erythema rating scale score in diabetes was 81% and in non-diabetes it was 39%. Finally, psychological and psychosexual problem frequency in diabetes was 100% and in non-diabetes was 88%. Conclusions: Women with diabetes had a fourfold risk of vulvodynia up to middle age as compared to non-diabetics in Peshawar, Pakistan. Diabetics with vulvodynia possessed a nine-fold risk of experiencing psychological symptoms of depression (OR = 9.33; 95% Cl 1.0-88.6) and an even higher risk of somatic depression symptoms.