OBJECTIVE: Vulval pain, in the absence of pathology, may have a psychological basis that relates to life events. This study aimed to determine the nature of such events. DESIGN: Structured questionnaire about patient's symptoms and early-life events. SETTING: Private practice physiotherapist specialising in pelvic floor disorders. POPULATION: Patients with vulvodynia as their primary symptom and control patients being treated for urinary tract disorder or post-childbirth routine physiotherapy who had no vulval pain on direct questioning. METHODS: Questionnaire applied to consecutive patients referred for treatment. Seventy-eight consecutive women presenting with vulvodynia (mean age 34 years, mean duration of symptoms 48 months) and 78 controls (mean age 39 years). MAIN OUTCOME MEASURES: Incidence of life events. RESULTS: A similar proportion of both groups were married. Being in a new relationship (P < 0.04), adverse current or previous relationships (39 versus 9%, P < or =
0.01), parental divorce (26 versus 9%, P < or = 0.001), history of termination of pregnancy, and adverse childbirth experiences (P < 0.04) were more common in patients than in controls. A history of sexual abuse was not more common in patients with vulvodynia compared with controls (13 versus 10%, P = not significant). Lack of libido was common in patients with vulvodynia (94 versus 29%, P < 0.0001). CONCLUSIONS: Adverse life experiences, including conflict, are common in women with vulvodynia. These factors may be important in mediating the genesis of pain through stress-related mechanisms. Sexual interest is diminished in these women. Sexual abuse is not a factor in most of these women. These findings have implications for treatment.