{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:51:31Z","timestamp":1793123491449,"version":"4.5.0"},"reference-count":169,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The management of vulval disorders in Genitourinary Medicine (GUM) clinics requires targeted approaches due to the wide range of conditions affecting the vulva. Vulval diseases encompass various aetiologies, including dermatoses, pain syndromes, and pre-malignant conditions, necessitating specialized care often involving multidisciplinary collaboration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This guideline aims to provide evidence-based recommendations for the diagnosis and management of specific vulval conditions that may present in GUM clinics. The focus is on conditions commonly managed by Genitourinary Physicians, either independently or in partnership with other specialists, depending on available local expertise. Additionally, guidance on onward referral is included to ensure optimal patient care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Sample<\/jats:title>\n                    <jats:p>The guideline primarily addresses the management of individuals aged 16 years and older presenting to GUM clinics with non-infective vulval conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection<\/jats:title>\n                    <jats:p>Recommendations within this guideline are derived from a review of existing literature, clinical expertise, and consensus among specialists. Emphasis is placed on diagnostic tests and treatment regimens tailored to the following conditions: Lichen sclerosus, Lichen planus, Eczema, Lichen simplex, Psoriasis, Vulval high-grade squamous intraepithelial lesions (previously vulval intraepithelial neoplasia), Vulval pain syndromes, and Non-sexually acquired acute genital ulceration (Ulcer of Lipsch\u00fctz).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This guideline offers practical recommendations for the effective management of specific vulval disorders in GUM settings. It is not intended to be a comprehensive review of all vulval diseases but rather a focused resource to assist clinicians in providing high-quality, patient-centred care. Onward referral pathways are also outlined to support collaborative and multidisciplinary management of complex cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09564624241311629","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T21:23:46Z","timestamp":1737494626000},"page":"346-371","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["2024 British Association for Sexual Health and HIV (BASHH) UK national guideline on the management of vulval conditions"],"prefix":"10.1177","volume":"36","author":[{"given":"Sarah K","family":"Edwards","sequence":"first","affiliation":[{"name":"Suffolk Sexual Health Services, Abbey View Clinic, Bury St Edmunds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Lewis","sequence":"additional","affiliation":[{"name":"Guy\u2019s &amp; St Thomas\u2019 Hospital, St John\u2019s Institute of Dermatology, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imali","family":"Fernando","sequence":"additional","affiliation":[{"name":"NHS Lothian, Chalmers Sexual Health Centre, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Haddon","sequence":"additional","affiliation":[{"name":"Royal Cornwall Hospitals NHS Trust, Truro, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0232-1583","authenticated-orcid":false,"given":"Deepa","family":"Grover","sequence":"additional","affiliation":[{"name":"Genitourinary and HIV Medicine and BASHH Clinical Effectiveness Group, Central North West London NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Standards of care for vulval conditions. https:\/\/bssvd.org\/wp-content\/uploads\/2020\/10\/Standards-of-Care_Vulval-Conditions-Report.pdf"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14096"},{"key":"e_1_3_3_4_2","unstructured":"British Association of Dermatologists. Patient information leaflets on vulval skincare. https:\/\/www.bad.org.uk\/pils\/vulval-skincare\/ (accessed 02 November 2022)."},{"key":"e_1_3_3_5_2","unstructured":"British Society for the Study of Vulval Disease. Patient information leaflets. Available at: https:\/\/www.bssvd.org\/leaflets.asp (accessed 02 November 2022)."},{"key":"e_1_3_3_6_2","unstructured":"British Association of Dermatologists. Patient information leaflets. Available at: https:\/\/www.bad.org.uk\/patient-information-leaflets (accessed 02 November 2022)."},{"key":"e_1_3_3_7_2","unstructured":"International Society for the Study of Vulval Disease. Patient information leaflets. Available at: https:\/\/www.issvd.org\/publications\/patient-handouts (accessed 02 November 2022)."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16175"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-4943(00)00059-5"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.16241"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13863-9"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1988.tb01748.x"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.34613"},{"key":"e_1_3_3_14_2","first-page":"9","article-title":"Lichen sclerosus et atrophicus","volume":"57","author":"Wallace HJ","year":"1971","unstructured":"Wallace HJ. Lichen sclerosus et atrophicus. Trans St John\u2019s Hosp Dermatol Soc 1971; 57: 9\u201330.","journal-title":"Trans St John\u2019s Hosp Dermatol Soc"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2015.0643"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.2005.02209.x"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2013.1987"},{"key":"e_1_3_3_18_2","first-page":"CD008240","article-title":"Topical interventions for genital lichen sclerosus (review)","volume":"7","author":"Chi CC","year":"2011","unstructured":"Chi CC, Kirtschig G, Baldo M, et al. Topical interventions for genital lichen sclerosus (review). Cochrane Libr 2011; 7: CD008240.","journal-title":"Cochrane Libr"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.14074"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12273"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12910"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2006.07446.x"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1159\/000096736"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2014.02.019"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.01103.x"},{"key":"e_1_3_3_26_2","first-page":"329","article-title":"Topical immunosuppressants, genital lichen sclerosus and the risk of squamous cell carcinoma: a case report","volume":"52","author":"Fischer G","year":"2007","unstructured":"Fischer G, Bradford J. Topical immunosuppressants, genital lichen sclerosus and the risk of squamous cell carcinoma: a case report. J Reprod Med 2007; 52: 329\u2013331.","journal-title":"J Reprod Med"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(94)70021-4"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2006.02082.x"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2013.7733"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/ski2.52"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000440"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15788"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-199603000-00023"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2005.01866.x"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1994.tb08468.x"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000307"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1996.tb03614.x"},{"key":"e_1_3_3_38_2","first-page":"67","article-title":"Severe vulvar scarring in patients with erosive lichen planus: a report of 4 cases","volume":"51","author":"Genadry R","year":"2006","unstructured":"Genadry R, Provost TT. Severe vulvar scarring in patients with erosive lichen planus: a report of 4 cases. J Reprod Med 2006; 51: 67\u201372.","journal-title":"J Reprod Med"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2005.12.006"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.142.3.289"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000384"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12334"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.12355"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.144.11.1432"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2004.01167.x"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2002.488713.x"},{"key":"e_1_3_3_47_2","first-page":"715","article-title":"Recalcitrant symptomatic vulvar lichen planus: response to topical tacrolimus","volume":"140","author":"Byrd JA","year":"2004","unstructured":"Byrd JA, Davis M, Rogers RS. Recalcitrant symptomatic vulvar lichen planus: response to topical tacrolimus. Arch Dermatol 2004; 140: 715\u2013720.","journal-title":"Arch Dermatol"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2005.06544.x"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e318258bf5b"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1080\/000155502753600966"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-0960.2008.00472.x"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2019.4062"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19870"},{"key":"e_1_3_3_54_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2012.10882.x"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.12763"},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-0960.2009.00536.x"},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.138.8.1100"},{"key":"e_1_3_3_58_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.16704"},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.14033"},{"key":"e_1_3_3_60_2","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2018.1463207"},{"key":"e_1_3_3_61_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1995.tb10841.x"},{"key":"e_1_3_3_62_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-0960.1996.tb00988.x"},{"key":"e_1_3_3_63_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1085-5629(98)80012-6"},{"key":"e_1_3_3_64_2","doi-asserted-by":"publisher","DOI":"10.1080\/01443610600747140"},{"key":"e_1_3_3_65_2","doi-asserted-by":"publisher","DOI":"10.1016\/0926-9959(95)96043-8"},{"key":"e_1_3_3_66_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2019.10.008"},{"key":"e_1_3_3_67_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-3083.2000.00080.x"},{"key":"e_1_3_3_68_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2008.01325.x"},{"key":"e_1_3_3_69_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-0960.2008.00442.x"},{"key":"e_1_3_3_70_2","doi-asserted-by":"publisher","DOI":"10.1111\/ced.12330"},{"key":"e_1_3_3_71_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1992.tb08403.x"},{"key":"e_1_3_3_72_2","doi-asserted-by":"publisher","DOI":"10.2310\/6620.2004.04004"},{"key":"e_1_3_3_73_2","doi-asserted-by":"publisher","DOI":"10.1097\/DER.0b013e318284da33"},{"key":"e_1_3_3_74_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.1997.tb00414.x"},{"key":"e_1_3_3_75_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000516"},{"key":"e_1_3_3_76_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.13375"},{"issue":"3","key":"e_1_3_3_77_2","first-page":"137","article-title":"Contact sensitivity in pruritus vulvae: patch test results and clinical outcome","volume":"8","author":"Lewis FM","year":"1997","unstructured":"Lewis FM, Shah M, Gawkrodger DJ. Contact sensitivity in pruritus vulvae: patch test results and clinical outcome. Am J Contact Dermat 1997; 8(3): 137\u2013140.","journal-title":"Am J Contact Dermat"},{"key":"e_1_3_3_78_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-0960.1996.tb00993.x"},{"key":"e_1_3_3_79_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2008.01417.x"},{"key":"e_1_3_3_80_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2007.01270.x"},{"key":"e_1_3_3_81_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8019.2008.00168.x"},{"key":"e_1_3_3_82_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1396-0296.2004.04002.x"},{"key":"e_1_3_3_83_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.15239"},{"key":"e_1_3_3_84_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012119.pub2"},{"key":"e_1_3_3_85_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14891"},{"key":"e_1_3_3_86_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2009.05.026"},{"key":"e_1_3_3_87_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2004.01680.x"},{"key":"e_1_3_3_88_2","first-page":"793","article-title":"The static physician\u2019s global assessment of genitalia: a clinical outcome measure for the severity of genital psoriasis","volume":"16","author":"Merola JF","year":"2017","unstructured":"Merola JF, Bleakman AP, Gottlieb AB, et al. The static physician\u2019s global assessment of genitalia: a clinical outcome measure for the severity of genital psoriasis. J Drugs Dermatol 2017; 16: 793\u2013799.","journal-title":"J Drugs Dermatol"},{"key":"e_1_3_3_89_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.17505"},{"key":"e_1_3_3_90_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-019-00447-5"},{"key":"e_1_3_3_91_2","doi-asserted-by":"publisher","DOI":"10.1177\/0956462419827673"},{"key":"e_1_3_3_92_2","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-0988"},{"key":"e_1_3_3_93_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-021-00536-6"},{"key":"e_1_3_3_94_2","doi-asserted-by":"publisher","DOI":"10.1177\/1203475419857668"},{"key":"e_1_3_3_95_2","doi-asserted-by":"publisher","DOI":"10.1111\/dth.13110"},{"key":"e_1_3_3_96_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.17147"},{"key":"e_1_3_3_97_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000169"},{"key":"e_1_3_3_98_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33198"},{"key":"e_1_3_3_99_2","unstructured":"UK national guidelines on the management of anogenital warts 2015 BASHH. Available at: https:\/\/www.bashhguidelines.org\/media\/1298\/agw-2015.pdf (accessed 02 November 2022)."},{"key":"e_1_3_3_100_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-021-07949-8"},{"key":"e_1_3_3_101_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000569"},{"key":"e_1_3_3_102_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000572"},{"issue":"1","key":"e_1_3_3_103_2","first-page":"10","article-title":"Risk factors to develop multicentric lesions of the lower genital tract","volume":"38","author":"Gonzalez-Bosquet E","year":"2017","unstructured":"Gonzalez-Bosquet E, Mazarico E, Lorente N, et al. Risk factors to develop multicentric lesions of the lower genital tract. Eur J Gynaecol Oncol 2017; 38(1): 10\u201313.","journal-title":"Eur J Gynaecol Oncol"},{"key":"e_1_3_3_104_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2017.10.029"},{"key":"e_1_3_3_105_2","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2013.24.3.236"},{"key":"e_1_3_3_106_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2015.12.012"},{"key":"e_1_3_3_107_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2016.02.015"},{"key":"e_1_3_3_108_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2020.05.054"},{"issue":"8","key":"e_1_3_3_109_2","first-page":"CD007924","article-title":"Medical interventions for high-grade vulval intraepithelial neoplasia","volume":"2015","author":"Pepas L","year":"2015","unstructured":"Pepas L, Kaushik S, Nordin A, et al. Medical interventions for high-grade vulval intraepithelial neoplasia. Cochrane Database Syst Rev 2015; 2015(8): CD007924.","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"e_1_3_3_110_2","first-page":"CD011837","article-title":"Medical and surgical interventions for the treatment of usual-type vulval intraepithelial neoplasia","volume":"2016","author":"Lawrie TA","year":"2016","unstructured":"Lawrie TA, Nordin A, Chakrabarti M, et al. Medical and surgical interventions for the treatment of usual-type vulval intraepithelial neoplasia. Cochrane Database Syst Rev 2016; 2016(1): CD011837.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_111_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000559"},{"key":"e_1_3_3_112_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000258783.49564.5c"},{"issue":"2","key":"e_1_3_3_113_2","first-page":"22","article-title":"Randomized, doubleblind, placebo-controlled trial for treatment of high grade vulval intraepithelial neoplasia with imiquimod","volume":"19","author":"Sterling JC","year":"2005","unstructured":"Sterling JC, Smith NA, Loo WJ, et al. Randomized, doubleblind, placebo-controlled trial for treatment of high grade vulval intraepithelial neoplasia with imiquimod. JEADV 2005; 19(Suppl 2): 22.","journal-title":"JEADV"},{"key":"e_1_3_3_114_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15124"},{"key":"e_1_3_3_115_2","first-page":"A108","article-title":"337 Primary imiquimod treatment versus surgery for vulvar intraepithelial neoplasia \u2013 PITVIN study. Baseline results of a randomized clinical trial","volume":"30","author":"Trutnovsky G","year":"2020","unstructured":"Trutnovsky G, Reich O, Joura EA, et al. 337 Primary imiquimod treatment versus surgery for vulvar intraepithelial neoplasia \u2013 PITVIN study. Baseline results of a randomized clinical trial. Int J Gynecol Cancer 2020; 30: A108.","journal-title":"Int J Gynecol Cancer"},{"key":"e_1_3_3_116_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60777-6"},{"key":"e_1_3_3_117_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-018-0707-9"},{"key":"e_1_3_3_118_2","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines9020083"},{"key":"e_1_3_3_119_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01973166"},{"key":"e_1_3_3_120_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16161"},{"key":"e_1_3_3_121_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-020-03647-y"},{"key":"e_1_3_3_122_2","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2008.519"},{"key":"e_1_3_3_123_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2021.02.098"},{"key":"e_1_3_3_124_2","doi-asserted-by":"publisher","DOI":"10.1177\/0956462416687913"},{"key":"e_1_3_3_125_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000190"},{"key":"e_1_3_3_126_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2011.08.012"},{"key":"e_1_3_3_127_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.12365"},{"key":"e_1_3_3_128_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2014.05.010"},{"key":"e_1_3_3_129_2","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3002613"},{"key":"e_1_3_3_130_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2018.07.011"},{"key":"e_1_3_3_131_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14157"},{"key":"e_1_3_3_132_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2011.02251.x"},{"key":"e_1_3_3_133_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31825957cf"},{"key":"e_1_3_3_134_2","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12668"},{"key":"e_1_3_3_135_2","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12685"},{"key":"e_1_3_3_136_2","first-page":"102","article-title":"Influence of oral contraceptive use on the risk of adult-onset vulvodynia","volume":"53","author":"Harlow BL","year":"2008","unstructured":"Harlow BL, Vitonis AF, Stewart EG. Influence of oral contraceptive use on the risk of adult-onset vulvodynia. J Reprod Med 2008; 53: 102\u2013110.","journal-title":"J Reprod Med"},{"key":"e_1_3_3_137_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.121869"},{"key":"e_1_3_3_138_2","doi-asserted-by":"publisher","DOI":"10.1080\/01443610400023106"},{"key":"e_1_3_3_139_2","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12367"},{"key":"e_1_3_3_140_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2005.02.020"},{"key":"e_1_3_3_141_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(01)00352-9"},{"key":"e_1_3_3_142_2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2010.2661"},{"key":"e_1_3_3_143_2","doi-asserted-by":"publisher","DOI":"10.1080\/00926230701866083"},{"key":"e_1_3_3_144_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2004.00297.x"},{"key":"e_1_3_3_145_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2482-8-13"},{"key":"e_1_3_3_146_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000021"},{"key":"e_1_3_3_147_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000682"},{"key":"e_1_3_3_148_2","unstructured":"Hospital anxiety and depression scale (HADS)."},{"key":"e_1_3_3_149_2","unstructured":"Dermatology quality of life index DLQI. Available at: https:\/\/www.bad.org.uk\/shared\/get-file.ashx?id=1653&itemtype=document (accessed 15 October 2021)."},{"key":"e_1_3_3_150_2","unstructured":"Patient information leaflet. Vulval pain society. Available at: https:\/\/vulvalpainsociety.org\/ (accessed 02 November 2022)."},{"key":"e_1_3_3_151_2","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12309"},{"key":"e_1_3_3_152_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2010.09684.x"},{"key":"e_1_3_3_153_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-017-1026-1"},{"key":"e_1_3_3_154_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2010.01941.x"},{"key":"e_1_3_3_155_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15223"},{"key":"e_1_3_3_156_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181e9e0ab"},{"key":"e_1_3_3_157_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1743-6109.2009.01642.x"},{"key":"e_1_3_3_158_2","first-page":"23","article-title":"The use of amielle vaginal trainers as adjuvant in the treatment of vestibulodynia: an observational multicentric study","volume":"10","author":"Murina F","year":"2008","unstructured":"Murina F, Bernorio R, Palmiotto R. The use of amielle vaginal trainers as adjuvant in the treatment of vestibulodynia: an observational multicentric study. Medscape J Med 2008; 10: 23.","journal-title":"Medscape J Med"},{"key":"e_1_3_3_159_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-018-3831-z"},{"key":"e_1_3_3_160_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2009.09.014"},{"key":"e_1_3_3_161_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01248.x"},{"key":"e_1_3_3_162_2","first-page":"435","article-title":"Long-term follow up of posterior vestibulectomy for treating vulvar vestibulitis","volume":"53","author":"Eva LJ","year":"2008","unstructured":"Eva LJ, Narain S, Orakwue CO, et al. Long-term follow up of posterior vestibulectomy for treating vulvar vestibulitis. J Reprod Med 2008; 53: 435\u2013440.","journal-title":"J Reprod Med"},{"key":"e_1_3_3_163_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-007-0501-y"},{"key":"e_1_3_3_164_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.lgt.0000225899.75207.0a"},{"key":"e_1_3_3_165_2","doi-asserted-by":"publisher","DOI":"10.1080\/13625187.2019.1643835"},{"issue":"2","key":"e_1_3_3_166_2","first-page":"103","article-title":"Evaluation of gabapentin in the treatment of generalized vulvodynia, unprovoked","volume":"52","author":"Harris G","year":"2007","unstructured":"Harris G, Horowitz B, Borgida A. Evaluation of gabapentin in the treatment of generalized vulvodynia, unprovoked. J Reprod Med 2007; 52(2): 103\u2013106.","journal-title":"J Reprod Med"},{"key":"e_1_3_3_167_2","doi-asserted-by":"publisher","DOI":"10.1155\/2007\/265148"},{"key":"e_1_3_3_168_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01803.x"},{"key":"e_1_3_3_169_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2008.09.031"},{"key":"e_1_3_3_170_2","doi-asserted-by":"publisher","DOI":"10.1177\/014107689909201110"}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624241311629","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09564624241311629","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624241311629","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:46:21Z","timestamp":1777675581000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09564624241311629"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,21]]},"references-count":169,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1177\/09564624241311629"],"URL":"https:\/\/doi.org\/10.1177\/09564624241311629","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,21]]}}}