Vulvar Vestibulitis: Challenges in Diagnosis and Treatment
“Localized vulvar pain syndrome is a persistent vulvar pain that can be consistently & precisely localised to the vulvar vestibule during physical examination, has no identifiable cause, & has been present for at least three months. This syndrome has previously been referred to as vulvodynia, vestibulodynia, vulvar vestibulitis, & focal vulvitis” [1]
This terminology confuses patients, and in many cases, general practitioners only have a rudimentary knowledge of the symptoms and conditions within this field. And this is why, in order to get an accurate diagnosis, and find out about the latest cutting-edge treatments, it is essential to see a Vulva Pain Specialist. Patients need to know that in a nutshell: “Vulvar vestibulitis, also known as VVS, is a type of vulvodynia, or pain around the vulva – the sex organs outside a woman’s body. The pain is in your vestibule, the part of your vulva around the opening of your vagina. It can cause redness and irritation of the skin and pain in the glands inside the skin” [2].
Getting a Correct Diagnosis
This should be the first course of action, which will take you on your way to recovery. Only visit an experienced Vulva Pain Specialist who has a track record in the field. Of note: “there are two main types of VVS: primary and secondary. If you have the primary type, you experience pain when you first use tampons, need a vaginal exam with a speculum, or start being sexually active. The secondary type begins after you’ve had sex without pain for a some time” [2].
During your consultation, your Vulva Pain Specialist will review your medical notes, conduct an examination (unless you are having an online consultation), and ask you various questions. The latter will include asking you whether you have had any of the following vulva vestibulitis symptoms:
•Pain from pressure (such as touch, tight clothes, working out, cycling, and sitting)
•Pain from inserting a tampon or having sex
•A sensation of burning
•Feeling as though your skin is raw
•Stinging
•Urinating more than usual, or suddenly feeling as though you have to pass water
•An irritating or strange vaginal discharge
•Small red spots just inside your vagina opening (around the vestibular glands) [2].
Once the Pain Specialist has gathered all the information, he/she will then discuss a Personalised Treatment Plan. This is designed to get you on the road to recovery as soon as possible.
References
[1]. Iglesia, C. (2020). “Clinical manifestations and diagnosis of vulvodynia (vulvar pain of unknown cause).” UpToDate.
https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-vulvodynia-vulvar-pain-of-unknown-cause
[2]. Cassoobhoy, A. (2020). “Vulvar Vestibulitis.”
HYPERLINK “https://www.webmd.com/women/guide/vulvar-