Vulvar vestibulitis

Definition:Inflammation of the tissue around the opening of the vagina that makes sexual activity painful.

Vulvar vestibulitis, also known as vestibulodynia or part of the broader condition vulvodynia, is a medical condition characterized by pain and discomfort in the vulvar vestibule, the area surrounding the entrance to the vagina. It falls under the category of vulvar pain disorders and is recognized for its specific symptom of pain upon pressure or touch, making activities such as sexual intercourse, tampon insertion, or gynecological examinations painful.

Symptoms and Diagnosis

Symptoms of vulvar vestibulitis include:

• Severe pain at the vestibule, the area around the entrance of the vagina.
• Burning sensations, itching, or rawness in the vulvar region.
• Pain during intercourse (dyspareunia), tampon insertion, or physical examination.

Diagnosis is primarily clinical, based on the patient's history and symptoms, along with a careful examination of the vulvar area. Pain localized to the vestibule upon gentle touch with a cotton swab is a common diagnostic criterion.

Causes and Risk Factors

The exact cause of vulvar vestibulitis is not fully understood, but several factors are believed to contribute to its development, including:

• Hormonal changes or imbalances.
• Genetic predisposition.
• Infections or chronic yeast infections.
• Autoimmune responses.
• Nerve injury or irritation.

Treatment

Treatment for vulvar vestibulitis varies and may include:

• Topical medications to reduce pain and inflammation.
• Oral medications, such as antidepressants or anticonvulsants, to manage pain.
• Physical therapy targeting pelvic floor muscles.
• Surgery, specifically vestibulectomy, in severe cases.
• Psychological counseling and sex therapy to address the emotional and psychological impacts.

Epidemiology

Vulvar vestibulitis is considered a relatively common condition among women of reproductive age, but its exact prevalence is difficult to determine due to underreporting and misdiagnosis.

History

The term "vulvar vestibulitis" was first introduced in the 1980s to describe this specific type of chronic vulvar pain. Since then, understanding and recognition of the condition have evolved, with ongoing research into its causes, diagnosis, and treatment.

See Also

• Vulvodynia
• Dyspareunia
• Gynecology
• Pelvic Floor Physical Therapy

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