Steroid receptor expression and morphology in provoked vestibulodynia

Objective This study was undertaken to survey the steroid receptor expression and morphology in the vulvar vestibular mucosa in women with provoked vestibulodynia. Study Design Fourteen patients and 25 controls without oral contraceptives were included. Vestibular biopsy specimens were obtained and analyzed by using immunohistochemistry, followed by computerized image analysis of estrogen receptors α and β, progesterone receptors A and B, glucocorticoid receptor, androgen receptor, and the proliferation marker Ki67. The morphology was estimated by measuring 4 parameters in the epithelium. Results There was a significantly higher expression of estrogen receptor α in both the epithelium ( P = .04) and the stroma ( P = .02) in the patient specimens compared with the controls. There were no significant differences in the other analyses performed. Conclusion There is an increased expression of estrogen receptor α in the vestibular mucosa but the epithelial morphology seems unaffected in women with provoked vestibulodynia. Further studies regarding plausible associations to neurogenic inflammation are needed.