Vulvar Vestibulitis

Vulvodynia is  the syndrome of unexplained vulvar pain and many women also have sexual dysfunction at the same time. The signs of vulvodynia are rawness, sting, irritation and or burning of the vaginal opening and surrounding tissues. It can be a source of psychological distress as well as even tampon insertion can be uncomfortable. Other women describe being unable to wear tight pants. There are apparently subtypes of vulvodynia, and one is vulvar vestibulitis.  Women who have pain at attempted intercourse when there is no infection may be suffering from vulvar vestibulitis. This is a confusing disorder of local vulvar pain, a sensation of irritation probably causes the feeling of rawness, and a chronic condition of vulvar tissues that are so paper thin they are prone to tearing. Women may complain of stinging, burning, and a hypersensitivity to touch, but about 15% of women describe the pain as knifelike. There is no known cause but we think that chronic infections, particularly yeast, hypersensitivity, or the human papilloma virus infection as well as high levels of a substance called oxylates in the urine may be the cause. Pelvic floor problems or pelvic nerve disruption can be part of the inciting cause. No one has established a perfect treatment. What women need in treatment is something to ease the skin irritation, not cause further sensitization of the area and yet be effective for pain relief. Numbing gels such as lidocaine lotions and lotions of Emla cream have been tried with some relief for some patients and it is tolerated on the sensitive genital tissues fairly well when used sparingly. Other things like pepper extract (capsacin), cromolyn, yeast treatments interferon and surgery have been tried. No one therapy has been proven to be very successful and the numbing treatments are thought to handle pain more than the condition itself.  If you have had a successful treatment, or if you are struggling with treatment, we'd like to hear your story.


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