Vulvar Vestibulitis Syndrome (VVS) is a highly underdiagnosed cause of superficial dyspareunia. Many women are told their pain is psychological when the issue is actually localized vestibulitis. In this article, I discuss VVS symptoms and treatments.
Recognizing Vulvar Vestibulitis
Pain is localized at the vaginal vestibule and triggered by contact, feeling like acid or salt on an open wound. The diagnosis is confirmed during examination via the Q-tip test (gentle pressure with a cotton swab triggers intense pain).
Treatment Strategies
Management includes topical nerve-calming ointments, pelvic physical therapy, and in refractory cases, Vestibulectomy (surgical excision of the painful tissue) which yields a 90% success rate.