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Female Sexual Dysfunction

Vulvar Vestibulitis

Vulvar vestibulitis is characterized by severe pain upon touch or pressure to the vulvar vestibule, causing significant discomfort during intercourse, tampon insertion, and gynecologic exams.

75%
Success Rate
3-6 months with conservative treatment; surgical recovery 6-8 weeks
Duration
Multiple
Treatment Options
3+ Groups
May Affect

What is Vulvar Vestibulitis?

Vulvar vestibulitis is characterized by severe pain upon touch or pressure to the vulvar vestibule, causing significant discomfort during intercourse, tampon insertion, and gynecologic exams.

Prevalence: Affects 10-15% of women; most common cause of entry dyspareunia

Symptoms and Signs

  • Sharp burning pain at vaginal opening with penetration
  • Pain with tampon insertion
  • Pain during gynecologic exams
  • Localized tenderness at 4-8 o'clock position
  • Redness of vestibular glands
  • Avoidance of sexual activity

Causes and Risk Factors

Common Causes

  • Chronic inflammation of vestibular glands
  • Nerve hypersensitivity
  • Pelvic floor muscle tension
  • Hormonal factors
  • Genetic predisposition

Risk Factors

  • ⚠️Recurrent yeast infections
  • ⚠️Long-term antibiotic use
  • ⚠️Oral contraceptive use
  • ⚠️Pelvic floor tension

Treatment Options

Expected Outcomes: 70-85% improvement with vestibulectomy; 50-60% with conservative therapy

Available Treatments:

  • Pelvic floor physical therapy
  • Topical lidocaine or estrogen
  • Tricyclic antidepressants
  • Vestibulectomy surgery
  • Cognitive behavioral therapy
  • Biofeedback therapy
  • Trigger point injections

Prevention Tips

  • Avoid irritants
  • Pelvic floor relaxation
  • Proper hygiene
  • Cotton underwear

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