Abstract
Vulvar vestibulitis syndrome, a condition characterized by inflammation of the vaginal introitus, causes chronic vulvar pain, particularly with intercourse. It occurs in at least 15% of women with chronic vulvovaginal symptoms, and it is a common cause of sexual dysfunction and resulting comorbidities. Because 80% of women with vulvar vestibulitis syndrome describe an acute onset of symptoms, an infectious etiology has been suspected but never proven. Initially, human papillomavirus infection was thought to be the cause, but recent controlled studies dispute this earlier supposition. Vulvovaginal candidiasis may play an important role in the development of this condition.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References and Recommended Reading
Nyirjesy P, Weitz MV, Grody MHT, Lorber B: Over-the-counter and alternative medicines in the treatment of chronic vaginal symptoms. Obstet Gynecol 1997, 90:50–53. This study analyzes self-use of a variety of over-the-counter and alternative medicines for chronic vulvovaginal symptoms. It also lists the types of conditions most commonly encountered in a vaginitis clinic. VVS was seen in 15% of patients.
Ashman RB, Ott AK: Autoimmunity as a factor in recurrent vulvovaginal candidosis and the minor vestibular gland syndrome. J Reprod Med 1989, 34:264–266.
Umpierre SA, Kaufman RH, Adam E, et al.: Human papillomavirus DNA in tissue biopsy specimens of vulvar vestibulitis patients treated with interferon. Obstet Gynecol 1991, 78:693–695.
Solomons CC, Melmed MH, Heitler SM: Calcium citrate for vulvar vestibulitis: A case report. J Reprod Med 1991, 36:879–882.
Bazin S, Bouchard C, Brisson J, et al.: Vulvar vestibulitis syndrome: An exploratory case-control study. Obstet Gynecol 1994, 83:47–50.
Sarma AV, Foxman B, Bayirli B, et al.: Epidemiology of vulvar vestibulitis syndrome: An exploratory case control study. Sex Trans Infect 1999, 75:320–326. This case-control study evaluates a variety of epidemiological factors in vulvar vestibulitis syndrome (VVS) patients and friend controls. It is the first study to suggest that vulvovaginal candidiasis (VVC) is seen more commonly than otherwise supected in VVS patients.
Bornstein J, Goldik Z, Stolar Z, et al.: Predicting the outcome of surgical treatment of vulvar vestibulitis. Obstet Gynecol 1997, 89:695–698. This study is an example of treatment outcomes that can be expected after surgical treatment for VVS.
Marinoff S, Turner M, Hirsch R, Richard G: Intralesional a interferon: Cost-effective therapy for vulvar vestibulitis syndrome. J Reprod Med 1991, 38:19–24.
Nyirjesy P, Halpern M: Medical management of vulvar vestibulitis: Results of a sequential treatment plan. Infect Dis Obstet Gynecol 1996, 3:193–197.
Glazer HI, Rodke G, Swencionis C, et al.: Treatment of vulvar vestibulitis syndrome with electromyographic biofeedback of pelvic floor musculature. J Reprod Med 1995, 40:283–290.
Chaim W, Meriwether C, Gonik B, et al.: Vulvar vestibulitis subjects undergoing surgical intervention: A descriptive analysis and histopathological correlates. Eur J Obstet Gynecol Reprod Biol 1996, 68:165–168.
Foster DC, Hasday JD: Elevated levels of interleukin-1b and tumor necrosis factor-a in vulvar vestibulitis. Obstet Gynecol 1997, 89:291–296. This study documents some of the local immunological changes in vestibular tissue, compared to controls. It also reveals some of the local cytokine changes that may influence the development of localized inflammation and tenderness.
Pyka RE, Wilkinson EJ, Friedrich EG: Histopathology of vulvar vestibulitis syndrome. Int J Gynecol Pathol 1988, 7:249–257.
Prayson RA, Stoler MH, Hart WR: Vulvar vestibulitis. Am J Surg Pathol 1995, 19:154–160.
Chadha S, Gianotten WL, Drogendijk AC, et al.: Histopathologic features of vulvar vestibulitis. Int J Gynecol Pathol 1998, 17:7–11.
Lundqvist EN, Hofer P-A, Olofsson JI, Sjöberg I: Is vulvar vestibulitis an inflammatory condition? A comparison of histological findings in affected and healthy women. Acta Derm Venereol 1997, 77:319–325.
Peckham B, Maki D, Patterson J, Gholan-Reza H: Focal vulvitis: A characteristic syndrome and cause of dyspareunia. Am J Obstet Gynecol 1986, 154:855–864.
Turner ML, Marinoff SC: Association of human papillomavirus infection with vulvodynia and the vulvar vestibulitis syndrome. J Reprod Med 1988, 36:533–537.
Wilkinson EJ, Guerrero E, Daniel R, et al.: Vulvar vestibulitis is rarely associated with human papillomavirus infection types 6, 11, 16, or 18. Int J Gynecol Pathol 1993, 12:344–349.
Marks TA, Shroyer KR, Markham NE, et al.: A clinical, histologic, and DNA study of vulvodynia and its association with human papillomavirus. J Soc Gynecol Investig 1995, 2:57–63.
Bornstein J, Shapiro S, Rahat M, et al.: Polymerase chain reaction search for viral etiology of vulvar vestibulitis syndrome. Am J Obstet Gynecol 1996, 175:139–144.
Ledger WJ, Polaneczky MM, Yih MC, et al.: Difficulties in the diagnosis of Candida vaginitis. Infect Dis Clin Pract 2000, 9:66–69. This study examines Candida culture to PCR, and also examines the accuracy of physician diagnosed VVC.
Fidel PL Jr, Sobel JD: Immunopathogenesis of recurrent vulvovaginal candidiasis. Clin Microbiol Rev 1996, 9:335–348.
Witkin SS, Jeremias J, Ledger WJ: Vaginal eosinophils and IgE antibodies to Candida albicans in women with recurrent vaginitis. J Med Vet Mycol 1989, 27:57–58.
Fidel PL Jr, Lynch ME, Redondo-Lopez V, et al.: Systemic cell-mediated immune reactivity in women with recurrent vulvovaginal candidiasis. J Infect Dis 1993, 168:1458–1465.
Chaim W, Foxman B, Sobel JD: Association of recurrent vaginal candidiasis and secretory ABO and Lewis phenotype. J Infect Dis 1997, 176:828–830.
Jeremias J, Ledger WJ, Witkin SS: Interleukin 1 receptor antagonist gene polymorphism in women with vulvar vestibulitis. Am J Obstet Gynecol 2000, 182:283–285. This study’s findings suggest that there is a genetic component to VVS.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Nyirjesy, P. Vulvar vestibulitis syndrome: A post-infectious entity?. Curr Infect Dis Rep 2, 531–535 (2000). https://doi.org/10.1007/s11908-000-0057-1
Issue Date:
DOI: https://doi.org/10.1007/s11908-000-0057-1