ABSTRACT
Many women with the multifaceted, poorly understood syndrome, vestibulodynia (VD), feel ignored when first seeking medical care for this confounding personal problem. Her minute-to-minute awareness is that her vulvar pain, whether constant or only with contact, is so severe that intercourse becomes a trial of pain. The specific diagnostic criteria included vulvar erythema of varying degree, pain on contact of the vestibular glands, and pain with any vaginal entry pressure on the vestibular glands. In addition to an inability to downregulate inflammation in some women with VD, there is evidence of increased peripheral nerve proliferation in the vulvar sites of patients with VD. History taking is a critical first step in making the diagnosis of VD. It requires patience and time to allow these women to state freely and without interruption all of their symptoms. In addition, symptomatic women are tested for infections or bacterial vaginosis more frequently than are asymptomatic women.
