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Vulvar vestibulitis: physical or psychosexual problem?

J Bornstein1, D Zarfati, Z Goldik

  • 1Department of Obstetrics and Gynecology, Carmel Medical Center and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa. mdjacob@tx.technion.ac.il

Obstetrics and Gynecology
|July 27, 2000
PubMed
Summary
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Surgical treatment for vulvar vestibulitis (painful intercourse) is effective, with high success rates. Research indicates vestibulitis is not a psychosexual issue, and psychological factors are likely results, not causes.

Area of Science:

  • Gynecology
  • Dermatology
  • Psychiatry

Background:

  • Vulvar vestibulitis is a condition characterized by pain during intercourse.
  • Its etiology has been debated, with theories suggesting psychosexual origins.

Purpose of the Study:

  • To investigate the physical versus psychosexual etiology of vulvar vestibulitis.
  • To evaluate the efficacy of surgical treatment for this condition.

Main Methods:

  • A comprehensive literature search of MEDLINE from January 1981 to June 1998 was conducted.
  • Publications focusing on surgical outcomes and the psychosexual theory were analyzed for study design, surgical techniques, and follow-up duration.

Main Results:

  • Surgical treatment (perineoplasty) for vulvar vestibulitis yielded significant symptom improvement in 89% of 646 women.

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  • Complete resolution of dyspareunia was reported in 72% of 512 women undergoing surgery.
  • No significant differences were found in marital satisfaction, psychological distress, or psychopathology between women with vestibulitis and the general population.

    • Conclusions:

    • The study concludes that vulvar vestibulitis is not a psychosexual problem and supports surgical intervention.
    • A high success rate can be achieved with appropriate surgical management.
    • Psychological findings may be consequences rather than causes of vulvar vestibulitis.