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mination and vulvodynia with ORs from 1.83 to 2.81. These associations were not observed in women with high diversity microbiomes. CONCLUSIONS Although there were no overall differences in microbiome profiles between cases and controls, vaginal microbiome diversity influenced associations between environmental and psychosocial risk factors and vulvodynia. However, it is unclear whether vaginal diversity modifies the association between the risk factors and vulvodynia or is altered as a consequence of the associations. Fungal infections have been inc