Vulvodynia & Vestibulitis
Vulvodynia is a chronic pain condition characterized by burning, stinging, irritation, and/or rawness in the female genital area, according to www.issvd.org. Pain is not always present solely with sexual intercourse or vaginal penetration but typically also occurs during everyday activities (a key way to help differentiate between vaginismus and vulvodynia).
Vulvar Vestibulitis Syndrome (VVS)
Vulvar vestibulitis is a common form of vulvodynia that has been described as one of the most common causes of genital and sexual pain in women, affecting upwards of 15% [Gardella, 2006]. VVS is specific to pain on touch and/or pressure only in the vestibule. The vulvar vestibule is the area within the inner lips surrounding the vaginal opening. VVS is typically diagnosed using Friedrich’s Criteria [Friedrich, 1987] which is:
- Severe pain in the vulvar vestibule upon touch or attempted vaginal entry
- Tenderness to pressure localized within the vulvar vestibule
- Vulvar erythema (inflammation) of various degrees
For diagnosis, a cotton-swab is typically used to place gentle pressure in the vestibule. If VVS is present, the cotton-swab test will often elicit severe pain or discomfort from the woman.
Like other pain causing conditions, any form of VVS may cause or contribute to problems with vaginismus and/or may coexist with vaginismus on an ongoing basis. As a result, women may need to address both conditions before they are able to fully restore fully pain-free intercourse.
Links of Interest
- National Vulvodynia Association
- International Society for the Study of Vulvovaginal Disease
- British Society for the Study of Vulval Disease
- Vulval Pain Society UK
- The Australian and New Zealand Vulvovaginal Society
- Polish Vulvodynia Site
- The V Book: A Doctor’s Guide to Complete Vulvovaginal Health by Elizabeth Stewart & Paula Spencer
- The Vulvodynia Survival Guide: How to Overcome Painful Vaginal Symptoms and Enjoy an Active Lifestyle by Howard Glazer
- The Vulva and Vagina Manual by Dennerstein by
For medical practitioners. Presents a scientific basis for diagnosis and management of vulval diseases.
Medical Studies & Articles
- Driver, K. (2002). Managing vulvar vestibulitis. The Nurse Practitioner, 27(7), 24-35.
- Metts, J. (1999). Vulvodynia and vulvar vestibulitis: Challenges in diagnosis and management. Available from American Family Physician (March 15, 1999) http://www.aafp.org/afp/990315ap/1547.html. Accessed 10 June 2004.
- Bergeron, S., Binik, Y.M., Khalife, S., Pagidas, K., Glazer, H. (2001). Vulvar vestibulitis syndrome: Reliability of diagnosis and evaluation of current diagnostic criteria. Obstet Gynecol, 98(1), 45-51.
- Friedrich, EG. (1987). Vulvar vestibulitis syndrome. J Reprod Med, 32(110), 110-4.
- Gardella, C. (2006). Vulvar vestibulitis syndrome. Curr Infec Dis Rep, 8(6), 473-480.
- Heim, L.J. (2001). Evaluation and differential diagnosis of dyspareunia. Am Fam Physician, 63(8), 1535-1544.