Comorbid Conditions of Ehlers-Danlos Syndromes and Vulvodynia: A Latent Class Analysis.

The study used an online survey, so participants' Ehlers-Danlos or hypermobility spectrum disorder diagnoses were self-reported and not confirmed by medical evaluation. Vulvodynia was screened with four questions, not diagnosed by pelvic exam, so screening positive is not a clinical diagnosis. The survey was cross-sectional, so it cannot show whether comorbid conditions came before or after vulvodynia symptoms. The sample was predominantly White (92.4%), so findings may not apply to people with Ehlers-Danlos or hypermobility spectrum disorders from other racial or ethnic backgrounds. The comorbid condition checklist was not exhaustive, and participants may have forgotten or not reported conditions. The vulvodynia screening tool may have weaknesses because some participants in the Other Pain Conditions class endorsed conditions that are often ruled out when diagnosing vulvodynia. Mast cell activation disorder was mistakenly listed as medium-acyl-CoA dehydrogenase on the checklist, so that indicator required expert reinterpretation. The analysis describes classes and screening likelihoods; it does not test whether any treatment reduces vulvodynia.

Do not read the 73% likelihood as a diagnosis of vulvodynia or proof that treatment works. Participants were screened, not diagnosed, and the cross-sectional survey cannot show that comorbidities caused vulvodynia.