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Association Between Vulvovaginal Discomfort and Activity of Inflammatory Bowel Diseases

      Background & Aims

      Inflammatory bowel diseases (IBD) affect 200–400 people per 100,000 in the United States, about half of whom are women. We aimed to define the prevalence of vulvovaginal symptoms and association with IBD activity in a large cohort of women.

      Methods

      Women more than 18 years old with IBD (1250) completed an online survey querying the presence and severity of vulvar or vaginal itch, burn, or irritation, vaginal discharge or dryness, and vulvovaginal pain. The survey collected information on demographic features and IBD activity (categorized using the Manitoba index). Women with and without symptoms were compared using bivariate analyses. Logistic regression evaluated associations between IBD severity and vulvovaginal symptoms, adjusted for diagnosis, menopause, smoking, depression, and use of medications to treat IBD.

      Results

      A total of 512 (41%) women reported at least 1 moderate–severe vulvovaginal symptom. All vulvovaginal symptoms except vaginal dryness were more common in women with active IBD. In a multivariate model controlled for menopause, smoking, t-score from the PROMIS depression instrument, and use of IBD medications, women with constant or frequent active IBD, based on Manitoba index scores, had increased odds for moderate–severe vulvovaginal symptoms (odds ratio, 1.68; 95% CI, 1.22–2.32) compared to women in remission. Vulvovaginal discomfort frequently or always decreased interest in sex (n=336; 28%) or ability to have sex (n=207; 16%).

      Conclusions

      In an online survey of 1250 women, we found that women with more active IBD have increased prevalence of vulvovaginal discomfort, compared to women in remission. These symptoms affect sexual health.

      Keywords

      Abbreviations used in this paper:

      BV (bacterial vaginosis), CCFA Partners (Crohn’s and Colitis Foundation online cohort), CD (Crohn’s disease), CI (confidence interval), IBD (inflammatory bowel disease), IC (indeterminate colitis), OR (odds ratio), PROMIS (Patient-Reported Outcomes Measurements Information System), UC (ulcerative colitis)
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      Linked Article

      • Predictors of Dyspareunia Among Female Patients With Inflammatory Bowel Disease
        Clinical Gastroenterology and HepatologyVol. 18Issue 4
        • Preview
          We read the recent paper published in Clinical Gastroenterology and Hepatology by Ona et al1 with interest. Sexual dysfunction is a well-recognized complication of chronic illness. In inflammatory bowel disease (IBD), such factors as age of diagnosis, increased bowel frequency, abdominal pain, fatigue, incontinence, perianal fistulas, abscesses, or skin tags may lead to an accumulation of physical and psychosocial factors that can impair sexual function. The authors reported that vulvovaginal discomfort was significantly associated with IBD activity, measured using validated symptom-based questionnaires in an online survey of 1250 women in the United States.
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