Localized Vulvar Dysesthesia

Aka: Localized Vulvar Dysesthesia, Localized Vulvodynia, Vestibulodynia, Vulvar Vestibulitis, Focal Vulvitis

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II. Definition

  1. Localized Vulvar Dysesthesia (Localized Vulvodynia)
    1. Localized Vulvar Pain without dermatitis
    2. The term, Vulvar Vestibulitis is a misnomer and is no longer used

III. Epidemiology

  1. Affects premenopausal women most commonly

IV. Etiology

  1. Unknown
  2. Possible causes
    1. Yeast Vaginitis
    2. Chemical irritants
    3. Local destructive therapy (CO2 Laser or Cryotherapy)
    4. Allergic Drug Reactions
    5. Human Papillomavirus

V. Findings: Symptoms and signs

  1. Persistent Dyspareunia at introitus
    1. Pain on penis or tampon entry
  2. Focal or diffuse erythema at vestibule
  3. Point tenderness at minor vestibular glands
    1. Swab lightly touched over area causes local pain

VI. Differential Diagnosis

  1. See Vulvodynia for differential diagnosis
  2. Signs active infection suggests other diagnosis
  3. Concurrent dermatitis suggests other diagnosis

VII. Course

  1. Lasts for months to years

VIII. Management

  1. See Vulvodynia

IX. References

  1. Black (1995) OBGyn Dermatology, Mosby-Wolfe
  2. Apgar (1996) Am Fam Physician 53(4):1171-80 [PubMed]
  3. Barhan (1997) Postgrad Med 102(3):121-32 [PubMed]
  4. Metts (1999) Am Fam Physician 59(6):1547-56 [PubMed]

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