Background The underlying causes of vulvar pain in women with vulvodynia remain poorly
understood. Catechol-O-methyltransferase, an enzyme that metabolizes catecholamines, is
a neuromodulator that is involved with perception and sensitivity to pain. The catechol-O-
methyltransferase gene is polymorphic, and a single nucleotide polymorphism is associated
with low activity and heightened pain sensitivity. The variant allele that encodes this
polymorphism commonly is called the “L allele” because of its low enzyme activity as …