Vulvar pain syndrome: a review

Area of Science:

• Gynecology
• Dermatology
• Pain Medicine

Background:

• Vulvar pain syndrome, encompassing conditions like vulvar vestibulitis and vulvodynia, was first described over a century ago.
• Despite extensive clinical observation, the etiology of this condition remains largely unknown.
• This review synthesits existing literature to clarify known facts and critically evaluate hypothetical causes.

Observation:

• Diagnosis relies on patient history of abrupt onset vestibular itching, burning, or dryness, often with prior misdiagnosis of fungal infections.
• Patients frequently report sexual discomfort or intolerance and a history of ineffective topical treatments.
• Physical examination commonly reveals vestibular hyperesthesia and varying degrees of erythema.

Findings:

• The causes of vulvar pain syndrome are not scientifically established.
• Many proposed etiological hypotheses lack a solid scientific foundation.
• Numerous therapeutic interventions have proven ineffective and may exacerbate patient discomfort.

Implications:

• The lack of understanding of vulvar pain syndrome's etiology hinders effective treatment development.
• Current treatment strategies are diverse but often fail to alleviate symptoms, indicating a need for evidence-based approaches.
• Further research is crucial to identify the underlying causes and develop targeted therapies for vulvar pain syndrome.