The journal article "Medical and Physical Predictors of Localized Provoked Vulvodynia" by Nina Bohm-Starke discusses predictors of localized provoked vulvodynia, a.k.a. vestibulitis).
Localized = in the vestibule rather than the vulva as a whole
Provoked = the pain is associated with penetration (by a tampon, or penis, or...)
- trauma to the vestibular mucosa develops greater pain sensitization in the peripheral and central nervous system (I discuss this in my "Pain is a Loop" post);
- greater pain perception
- proliferation of mast cells in the vestibule
- pelvic floor muscle dysfunction
- concurrent bodily pain in other areas of the body
- history of hives (2.5 times more likely)
- bacterial vaginosis*
- genetics - allele 2 of the IL-1beta gene in 40% of women versus 25% control; reduced capacity of TNF-alpha production in response to microbes with polymorphism of the mannose-binding lectin gene; fair skinned women; and when there is polymorphism of the melanocortin-1 receptor (MCIR) gene
- hormones (read article for greater depth), with birth control thought to be a significant precursor according to Andrew Goldstein.