The DOI matches its Crossref record; 17 of the 17 references it cites were found in a registry or an index; none of the 13 sources its claims cite is checked for support yet.
Prevalence of symptoms consistent with a diagnosis of vulvodynia: population-based estimates from 2 geographic regions
Open accessAbstract
Objective We used validated sensitive and specific questions associated with clinically confirmed diagnoses of unexplained vulvar pain (vulvodynia) to compare the cumulative incidence of vulvar pain and prevalence of care-seeking behavior in Boston metropolitan area (BMA) and in Minneapolis/Saint Paul metropolitan area (MSP) from 2001 through 2005 using census-based data, and 2010 through 2012, using outpatient community-clinic data, respectively.Study design We received self-administered questionnaires from 5440 women in BMA and 13,681 in MSP, 18-40 years of age, describing their history of vulvar burning or pain on contact that persisted >3 months that limited/prevented intercourse.Results By age 40 years, 7-8% in BMA and MSP reported vulvar pain consistent with vulvodynia. Women of Hispanic origin compared to whites were 1.4 times more likely to develop vulvar pain symptoms (95% confidence interval, 1.1-1.8). Many women in MSP (48%) and BMA (30%) never sought treatment, and >50% who sought care with known health care access received no diagnosis.Conclusion Using identical screening methods, we report high prevalence of vulvar pain in 2 geographic regions, and that access to health care does not increase the likelihood of seeking care for chronic vulvar pain.
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In the paper
“We were the first to show this association1 and have now replicated this previous finding in a second geographical location.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > COMMENT
What the sources say
- Not checked yetcites [1] Harlow, 2003, A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia?, J Am Med Womens Assoc
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“even within the BMA sample, more than 30% were unable to receive a diagnosis”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > RESULTS
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the age-specific risk of vulvodynia in the BMA sample was similar to that in the MSP sample across each of the age categories.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > RESULTS
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“By age 40, 7–8% in BMA and MSP reported vulvar pain consistent with Vulvodynia.”
- Also stated in: § RESULTS · hedged
“These results suggest that by age 40, 7–8% of women will have experienced symptoms consistent with vulvodynia.”
- Also stated in: § COMMENT · hedged
“approximately 8% of women may experience these symptoms by the age of 40.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > Abstract > RESULTS
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § RESULTS · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“women in the MSP and BMA samples were within approximately one percentage point of each other, suggesting no appreciable difference in vulvodynia incidence between the two populations.”
- Also stated in: § COMMENT · plain
“we observed a similar cumulative incidence for symptoms consistent with vulvodynia across two geographical regions in which the source population differed.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > RESULTS
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § COMMENT · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“more than 50% reported being unable to receive a diagnosis, irrespective of timing of pain onset.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > RESULTS
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“of those who sought treatment, there was little difference in the number of clinicians seen by primary versus secondary onset of pain”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > RESULTS
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Women of Hispanic/Latina origin compared to Caucasians were 1.4 times more likely to develop vulvar pain symptoms (95%CI: 1.1–1.8).”
- Also stated in: § RESULTS · plain
“combined across both geographic regions, by age 40 Hispanic/Latina women were 1.4 times more likely to develop vulvar pain compared to Caucasian women (95% CI 1.1–1.8).”
- Also stated in: § COMMENT · plain
“the risk of developing this condition by the age of 40 is higher among Hispanic/Latina women than White women.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > Abstract > RESULTS
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“>50% who sought care with known health care access received no diagnosis.”
- Also stated in: § RESULTS · plain
“within the MSP sample, more than 50% received no diagnosis for their condition.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > Abstract > RESULTS
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“those in the BMA sample were more likely to seek care from more than two clinicians compared to women in the MSP sample”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > RESULTS
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
- It may state two separate claims as one. 11
- The quote only partly states this claim. 1
- Probably not a substantial claim. 7
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the rate of first onset of vulvar pain was greatest before the age of 25, decreased during the late 20s and early 30s, and then rose again as women approached their later reproductive years.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > RESULTS
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This can be empirically quantified as a Risk Difference of 18% (95% CI= 11.3–24.6).”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > RESULTS
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one. The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Many women in MSP (48%) and BMA (30%) never sought treatment”
- Also stated in: § RESULTS · plain
“there were still a substantial proportion of both samples of women who never sought treatment (48% in MSP, 30% in BMA).”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > Abstract > RESULTS
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Also stated in: § RESULTS · plain
In the paper
“we previously reported that women reporting pain on contact for a period of three months or longer that limited or prevented intercourse was associated with an 83% sensitivity and 94% specificity for meeting a true diagnosis of vulvodynia based on the gold standard of a clinical examination to rule out other known causes of vulvar pain.5”
- Also stated in: § COMMENT · plain
“we used a set of questions that were validated against the gold standard of a clinical examination consistent with an 83% sensitivity and 95% specificity.5”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > MATERIALS AND METHODS > Classifying vulvar pain and assessing care-seeking behavior
What the sources say
- Not checked yetcites [5] Harlow, 2009, Self-reported vulvar pain characteristics and their association with clinically confirmed vestibulodynia, J Womens Health source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Also stated in: § COMMENT · plain
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Without an actual clinical examination, we cannot be sure that those classified as having symptoms consistent with vulvodynia would in fact meet the existing or future clinically-confirmed diagnostic criteria for this condition. Thus, our estimates of age-specific risk and cumulative incidence across two geographical regions will likely include some degree of misclassification.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > COMMENT
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, in the MSP sample, 15% of the participants were non-White allowing for reasonable analytical comparisons to the BMA sample.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > RESULTS
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“vulvodynia (chronic vulvar pain in the absence of objective abnormalities such as infection or dermatoses), is highly prevalent with lifetime estimates ranging from 10–28% among reproductive-aged women in the general population.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > INTRODUCTION
What the sources say
- Not checked yetcites [1] Harlow, 2003, A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia?, J Am Med Womens Assoc
- Not checked yetcites [2] Reed, 2008, Vulvodynia incidence and remission rates among adult women: a 2-year follow-up study, Obstet Gynecol source
- Not checked yetcites [3] Reed, 2004, Pain at the vulvar vestibule: a web-based survey, J Low Genit Tract Dis source
- Not checked yetcites [4] Arnold, 2007, Assessment of vulvodynia symptoms in a sample of US women: a prevalence survey with a nested case control study, Am J Obstet Gynecol source
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“we can also not rule out selection bias as a potential explanation for these differences (consistent in both geographical regions) if, in truth, there are differences by race among those with vulvar pain who do and do not agree to participate in the survey.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > COMMENT
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“clinic-based assessments do not accurately estimate prevalence because it includes only those women who choose to seek treatment and ultimately receive a diagnosis, which represents approximately half of those who truly have this condition in the general population as shown in these and our earlier findings.1”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > COMMENT
What the sources say
- Not checked yetcites [1] Harlow, 2003, A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia?, J Am Med Womens Assoc
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Separate logistic models were used to determine the adjusted proportion of women who sought treatment, and whether or not a diagnosis was obtained, adjusted for the women’s age at the time of the survey, race, and the length of time they had suffered from vulvodynia-like symptoms.”
- Also stated in: § RESULTS · plain
“Table 3 restricts the samples to those reporting symptoms consistent with vulvodynia to assess healthcare seeking behavior after adjustment for age, race, and length of time suffering from vulvar pain.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > MATERIALS AND METHODS > Statistical methods
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- Also stated in: § RESULTS · plain
In the paper
“There were no clinically meaningful differences in the proportion of women reporting difficulty and/or pain with first tampon use between the two samples suggesting comparability in early life exposures that may contribute to vulvar pain onset later in life.1”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > RESULTS
What the sources say
- Not checked yetcites [1] Harlow, 2003, A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia?, J Am Med Womens Assoc
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We suspect any misclassification would be non-differential across region, biasing our estimates of the difference between region toward the null, on average.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > COMMENT
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
In the paper
“the cumulative incidence decreased with increasing age, with nearly half of all women affected choosing not to seek treatment.1”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > INTRODUCTION
What the sources say
- Not checked yetcites [1] Harlow, 2003, A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia?, J Am Med Womens Assoc
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“After three mailings, 13,681 women (53.1%) returned a completed questionnaire that included all key questions needed for this analysis.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > MATERIALS AND METHODS > Population-sampling frame, Minneapolis/St, Paul Metropolitan Area (MSP)
Strength:plain· not yet calibratedn = 13,681Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“All ethnicities we sampled were affected, with a somewhat greater occurrence among Hispanic/Latina women.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > INTRODUCTION
What the sources say
- Not checked yetcites [1] Harlow, 2003, A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia?, J Am Med Womens Assoc
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“we can also not rule out that our prevalence estimates may be potentially over-inflated, since women with a history of vulvar pain may have been more likely to agree to complete our screener interview.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > COMMENT
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“after two mailings and one telephone follow-up assessment, 67.2% completed the questionnaire.”
§ Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-based estimates from two geographical regions > MATERIALS AND METHODS > Population-sampling frame, Boston Metropolitan Area (BMA)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
The BMA and MSP samples are representative of women aged 18–40 in their respective geographic regions.
“we were able to assess the magnitude of this problem in women from community-based samples rather than clinical specialty practices.”
The paper relies on this without support.
Women accurately reported their age at first onset of vulvar pain.
“Self-reported age at first onset of vulvar pain was obtained and used to estimate age-specific cumulative incidence”
The paper relies on this without support.
Women accurately reported their care-seeking behavior and whether they received a diagnosis.
“We estimated what proportion of women sought treatment, how many different clinicians were seen to address their vulvar pain, and whether they were able to receive a diagnosis (either correct or incorrect based on the respondent’s self-report).”
The paper relies on this without support.
Non-respondents are similar to respondents on characteristics other than age that are relevant to vulvar pain.
“In both the BMA and the MSP sample, respondents and non-respondents were comparable by age”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Approximately 40 % of women with vulvodynia refrain altogether from seeking help, in many cases because of stigma associated with the conditions [7, 19, 20]”
From A feasibility trial of online Acceptance and Commitment Therapy for women with provoked vestibulodynia (2023) · cites this paper as [7]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Conflicting specificity for the screening questions
MinorThe methods report 94% specificity for the screening questions, while the discussion reports 95% specificity for questions validated against a clinical examination.
“associated with an 83% sensitivity and 94% specificity for meeting a true diagnosis of vulvodynia”
“consistent with an 83% sensitivity and 95% specificity.5”
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Metadata
- Authors
- Harlow, B. L., Kunitz, C. G., Nguyen, R. H. N., Rydell, S. A., Turner, R. M., & MacLehose, R. F.
- Affiliations
- University of Minnesota (US)
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 210
- Issue
- 1
- Pages
- 40.e1-40.e8
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC3885163
- OpenAlex
- W2023517643
- Cited by
- 322
- References
- 16
- Citations by year
- 2026: 19 · 2025: 30 · 2024: 22 · 2023: 24 · 2022: 24 · 2021: 27 · 2020: 30 · 2019: 29 · 2018: 28 · 2017: 33 · 2016: 25 · 2015: 23 · 2014: 7
- FWCI
- 13.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (R01-HD384285, R01-HD058608)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Surgery › Genital Health and Disease
- Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
- Keywords
- vulvodynia, vulvar pain, prevalence, care-seeking behavior, health care access, Hispanic women, chronic vulvar pain, women's health, Boston metropolitan area
- MeSH terms
- Adolescent, Adult, Ethnicity, Female, Health Services Accessibility, Humans, Surveys and Questionnaires, United States, Incidence, Prevalence, Young Adult, Vulvodynia
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