Vulvar Vestibulitis Syndrome (VVS) or Vestibulodynia is a disorder that is associated with painful vaginal penetration. Vestibulodynia has been described as a triad that includes:
- pain with vaginal penetration
- elicited tenderness upon of the vestibule
- redness of the vestibular tissue on visual examination
A woman with Vestibulodynia may present with varying degrees of symptoms which include tearing, rawness, stingingand irritation but their main complaint is usually painful intercourse. Symptoms can be provoked by a finger, tampon, speculum and/or penis. In severe cases, women may find it difficult to sit, jog, bicycle or wear snug jeans.
What causes Vestibulodynia?
The limited amount of research to date has provided no clear understanding of what causes Vestibulodynia. Genetic, hormonal, environmental, infectious and immunologic etiologies have been tested without discovering a distinct etiology.
Treatment options include both medical and surgical choices. Some women prefer a non-surgical option. Non-surgical options have been found to reduce and even cure Vestibulodynia. One of these options involves treatment with a specialized skin, non-burning, laser: Nd: YAG. Currently, it is postulated that the laser’s energy leads to remodeling of the sub dermal tissue. This is where the tissue support mechanism lies and includes nerves, collagen, and blood vessels. Tissue studies have shown an increased density of nerve and blood vessels in women with Vestibulodynia. Likely, laser treatment alters this tissue so that the mechanism of pain slowly diminishes. This is a non-surgical, outpatient treatment using only topical anesthesia (lidocaine) and is very well tolerated. In our experience at OHSU, 68% of women suffering from Vestibulodynia reported an improvement in their pain. This is comparable to the data supporting surgical resection of the vestibule and provides an alternative to surgery.