DR. NYIRJESY is Professor of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pa.
Diagnosing and treating women with vulvar vestibulitis can sometimes seem more art than science. Here an expert reviews the available evidence and describes his approach.
A few words about terminology
What is vulvar vestibulitis syndrome?
VVS is a condition whose primary hall-mark is dyspareunia with intromission. Although exact data on the prevalence of VVS in the general population remain scarce, certain studies suggest that it's a common condition. In a mail and telephone survey of 4,915 Boston-area women, Harlow and colleagues found that 16% of surveyed women reported a history of chronic knifelike or excessive pain on contact with the genital area lasting for at least 3 months or longer, and 7% were experiencing it at the time of the survey.3 Similarly, we've found VVS in up to 15% of patients referred to a tertiary care center for evaluation of chronic vaginal and vulvar symptoms.4 These studies suggest that VVS is a fairly common cause of vulvar pain.