Vulvar Vestibulitis

Vestibulitis is a condition that causes redness and pain of the vestibule. Vestibulitis is an inflammation of this skin and the mucous secreting glands found in the skin. The mucous secreting glands are called the lesser vestibular glands. Vestibulitis may include all the area around the opening of the vagina but is most commonly seen in the lower part.

Vulvar vestibulitis occurs in women of all ages. It can occur in women who are sexually active and also in women who have never been sexually active.

Many women with this problem have suffered physically and emotionally for months or years, have seen a number of physicians and have tried many unsuccessful treatments in search of relief.

What are the signs and symptoms of Vulvar Vestibulitis?

  • Severe pain with pressure (for example: biking, exercise, tight fitting clothes).
  • Vaginal entry such as tampon use or intercourse.
  • Burning, stinging, irritation or raw sensation within the vestibular area.
  • Vestibular redness
  • The urge to urinate frequently or suddenly

How is vulvar vestibulitis diagnosed (identified)?

Your doctor or health care provider will examine the vulva and vestibule to identify the common skin changes seen with vulvar vestibulitis. Pain is usually felt if the vestibule area is touched with a cotton tipped applicator. A sample of your vaginal discharge is collected and tested to rule out infection.

What is the cause of vulvar vestibulitis?

The exact cause is unknown, but many studies are being conducted to determine the cause of vulvar vestibulitis.

The following factors have been associated with vulvar vestibulitis:

  • HPV (Human Papilloma Virus)
  • Chronic yeast infections
  • Chronic bacterial infections
  • Chronic changes of pH (acid-base balance in the vagina)
  • Chronic use of chemicals/irritants such as detergents, soaps, spermicides or lubricants.

What is the treatment for vulvar vestibulitis?

Treatment may include any of the following:

  • Follow the Vulvar Skin Care Guidelines.
  • Steroid ointments
    • How it is used: A thin layer is applied to the areas of discomfort.
    • How it works: Decreases redness, irritation, and burning.
    • Caution: Use only as prescribed by your doctor. Overuse may result in thinning of the skin that will make your problem worse rather than helping it.
     
  • Trichloroacetic Acid (TCA) may be used in some cases as determined by the severity of the symptoms you have. TCA is a chemical that is used to destroy small areas of the irritated skin allowing new healthy skin to grow in its place.
  • Interferon injections are used to increase your body's response to infection.
  • Surgery or laser is used to remove involved skin areas. This method is not recommended in our clinic.

Helpful treatment hints:

A and D Ointment
  • How it is used: Apply to the areas of discomfort.
  • How it Works: Protects the skin, decreases irritation, heals and soothes.
Lidocaine Gel may be prescribed after initial treatment.
  • How it is used: Apply to the areas of discomfort.
  • How it Works: Numbs areas before intercourse.
  • Caution: After applying, wait until area becomes less sensitive before intercourse. Burning may occur for a short time (five to 10 minutes) after the gel is applied.
Witch Hazel Pads (TUCS Pads)
  • How it is used: Apply to the areas of discomfort.
  • How it Works: Decreases burning and irritation after intercourse and urinating.
Cleansing Bottle
  • Pour plain luke-warm water over the vulva after urinating to remove urine from irritated area.
Calcium Citrate Tablets
  • How it is used: Take orally 1200-1800mg. elemental calcium every day.
  • How it works: Thought to decrease certain crystals in the urine that may cause burning.
Limit High Oxalate Foods
  • May decrease amount of oxalate crystals in urine. Oxalate crystals cause urinary symptoms such as the urge to urinate frequently or suddenly.
Baking Soda Soak
  • Soak in luke warm bath water with four to five tablespoons of baking soda to help soothe vulvar itching and burning. Soak one to three times a day for 10 to 15 minutes. If you are using a sitz bath, use one to two teaspoons of baking soda.