Vulvar vestibulitis: prevalence and historic features in a general gynecologic practice population

All gynecologic patients seen by the author during a 6-month period were questioned and examined by means of a swab test to determine the prevalence of vulvar vestibulitis and the normal variation in sensitivity of vestibular skin. Of 210 patients, 78 (37%) had some degree of positive testing. A total of 31 patients (15%) were found to fulfill the definition of vulvar vestibulitis. A questionnaire was administered to these patients as well as to seven patients in whom vestibulitis had been previously diagnosed. A total of 50% had always had pain, most since their teenage years. Their history was not suggestive of a cyclic or remittent pattern of symptoms. Those with secondary dyspareunia or resolution of pain were usually either in a post partum phase or had group B streptococcus or human papillomavirus. The two most severe cases of vestibulitis occurred after use of fluoroucil cream. A total of 32% had some female relative with dyspareunia or tampon intolerance, raising the issue of a genetic predisposition.