OurGYN

Vulvar vestibulitis syndrome (also know as vestibulodynia or vestibular adenitis)  is a subset of vulvodynia that is characterized by severe pain during attempted vaginal entry (intercourse or tampons insertion), tenderness to pressure localized to the vulvar vestibule and redness of the vulvar vestibule (click for photos of vestibulitis).   Increased awareness of vestibulitis has led to exciting new research and it has become apparent that vestubilitis is not just one disease but is in fact just a symptom of several different disease or conditions.

On ABC TV's 20/20 on August 7, 2009, Dr. Timothy Johnson, ABC News’ chief medical editor, discussed the diagnosis and treatment of sexual pain disorders with Dr. Andrew Goldstein, Director of the Center for Vulvovaginal Disorders and author and educator, and Amy Stein, MPT, a physical therapist who specializes in the treatment of chronic pelvic and urogynecological pain. Dr. Goldstein is the medical director of ourgyn.com. To view the segment click here . Click here to discuss these issues on our Bulletin Board.

Odyne was the "Greek goddess of pain." Therefore, the term vulvodynia literally means "vulvar pain." Vulvodynia is currently defined as "vulvar discomfort, most often described as burning pain, occurring in the absence of relevant visible findings or a specific, clinically identifiable disease" This classification acknowledges that vulvar pain may be attributable to diagnosable and treatable disorders such as infections (yeast, trichomonas), dermatologic disorders (lichen sclerosus, lichen planus, plasma cell vulvitis), hormonal (atrophic vulvovaginitis) and neurologic disorders (pudendal neuralgia, pudendal nerve entrapment, and post-herpetic neuralgia.) However, these definable causes of vulvar pain are not defined as vulvodynia.   Therefore, while many women are referred to the Centers for Vulvovaginal Disorders with the diagnosis of "vulvodynia," the physicians at the CVVD only rarely give this diagnosis because they are very skilled in the diagnosis of the specific diseases that cause vulvar pain.

Interstitial Cystitis (IC), also called Painful Bladder Syndrome (PBS), is linked to dyspareunia (pain with intercourse) and is thought of as contributing to long term female sexual dysfunction. Interstitial cystitis is the most therapeutically frustrating condition of the urinary tract.

Your visit to the gynecologist has ended with you thinking that you’re crazy. You’ve got vaginal burning, pain, and rawness that won’t go away. Your genital area may be red and irritated looking. Your doctor has said that there is no infection, nor any other disease that is causing the problem. You’ve tried creams, over-the-counter yeast infection treatments, and every other itching treatment available. It’s not in your head; you are not losing your mind. It could be vulvodynia.

Vulvar vestibulitis syndrome (also know as vestibulodynia or vestibular adenitis)  is a subset of vulvodynia that is characterized by severe pain during attempted vaginal entry (intercourse or tampons insertion), tenderness to pressure localized to the vulvar vestibule and redness of the vulvar vestibule (click for photos of vestibulitis).   Increased awareness of vestibulitis has led to exciting new research and it has become apparent that vestubilitis is not just one disease but is in fact just a symptom of several different disease or conditions.

Millions of Americans suffer from chronic fatigue syndrome, endometriosis, interstitial cystitis, irritable bowel syndrome, temporomandibular joint and muscle disorders, and vulvodynia. Current research indicates that these conditions frequently coexist or 'overlap,' yet all of the disorders are poorly understood.

Pelvic Floor disorders can be painful, disruptive, and emotionally stressful and upsetting. If misdiagnosed, as they frequently are, they may lead to unnecessary and therefore destructive drug therapies or even surgical procedures. Even without such extreme effects, these disorders can cause life-changing results—including organ prolapse, incontinence, skin disorders, and sexual dysfunction.

Amy Stein is regular contributor to Vibrance Associates sites and their forums.  Rather than excerpt a single chapter from her new book, Ms. Stein has chosen information from various chapters to share from her book, Heal Pelvic Pain: The Proven Stretching, Strengthening and Nutrition Program for Relieving Pain, Incontinence, I.B.S. and other Symptoms without Surgery (McGraw Hill, 2008) Published with permission. This is the first of four parts.