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Authors: Dr Yi Jia Lee, Resident Medical Officer, King Edward Memorial Hospital, Perth Australia; Dr Varitsara Mangkorntongsakul, Dermatology Research Fellow, The University of Sydney, Australia; Dr Bernadette McElhinney, Consultant Obstetrician Gynaecologist, Perth, Australia. Copy edited by Gus Mitchell. September 2021
Oestrogen hypersensitivity vulvitis is a rarely reported form of chronic cyclic vulvovaginitis due to endogenous or exogenous oestrogen allergy.
Oestrogen hypersensitivity vulvitis has been reported in a very small number of mostly premenopausal women (age range 11–48 years) with a mean age of onset of symptoms of 26 years. Most (but not all) have been previously exposed to exogenous hormones such as the oral contraceptive pill. The majority have never been pregnant at the time of diagnosis.
Post-menopausal women on hormone replacement therapy (age range 47–63 years) have been rarely described, with constant symptoms rather than a cyclic pattern.
Sex hormone levels over the menstrual cycle
Oestrogen hypersensitivity vulvitis is localised to the vulva perhaps due to the sensitivity of genital oestrogen receptors.
Oestrogen hypersensitivity sensitivity vulvitis is probably a dose-dependent type IV reaction [see Allergies explained].
Oestrogen hypersensitivity vulvovaginitis is a clinical diagnosis based on the cyclic pattern of symptoms and failure to respond to standard treatments for vulval itch.
Oestrogen hypersensitivity vulvitis resolves at menopause.
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