Vulvar Vestibulitis
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What Every Dad and Husband Needs to Know About Vulvar Vestibulitis

Vulvar Vestibulitis is a condition which causes redness and pain of the vestibule. Vestibulitis is an inflammation of this skin and the mucous secreting glands found in the skin. The mucous secreting glands are called the lesser vestibular glands.  

Vulvar Vestibulitis may include all the area around the opening of the vagina but is normally seen in the lower part of the vaginal opening.

Vulvar vestibulitis occurs in women of all ages. It can occur in women who are sexually active and also in women who have never been sexually active.  

Many women with this problem have suffered physically and emotionally for months or years, have seen a number of physicians, and have tried many unsuccessful treatments in search of relief.  

What are the signs and symptoms of Vulvar Vestibulitis?

*  Severe pain with pressure (for example: biking, exercise, tight fitting clothes ).

*  Vaginal entry such as tampon use or intercourse. 

*  Burning, stinging, irritation, or raw sensation within the vestibular area.

* Vestibular redness 

*  The urge to urinate frequently or suddenly.   

How is vulvar vestibulitis diagnosed (identified)?

Your doctor or health care provider will examine the vulva and vestibule to identify the common skin changes seen with vulvar vestibulitis. Pain is usually felt if the vestibule area is touched with a cotton tipped applicator. A sample of your vaginal discharge is collected and tested to rule out infection.

What causes vulvar vestibulitis? 

The exact cause is unknown, but many studies are being conducted to determine the cause of vulvar vestibulitis.  

The following factors have been associated with vulvar vestibulitis:

*  HPV (Human Papilloma Virus)
*  Chronic Yeast Infections
*  Chronic bacterial infections 
*  Chronic changes of pH (acid-base balance in the vagina)
*  Chronic use of chemicals/irritants such as detergents, soaps, spermicides or lubricants.

What is the treatment for vulvar vestibulitis?  

Treatment may include any of the following:  

*  Follow the Guidelines for Vulvar Skin Care
*  Steroid Ointments 

How it is used: A thin layer is applied to the vulvovaginal areas. 

How it Works: Decreases redness, irritation, and burning. Caution: Use only as prescribed by your doctor. Overuse may result in thinning of the skin which will make your problem worse rather than helping it.

*  Trichloroacetic Acid (TCA) may be used in some cases as determined by the severity of the symptoms you have. TCA is a chemical that is used to destroy small areas of the irritated skin allowing new healthy skin to grow in its place. 

*  Interferon Injections are used to increase your body's response to infection. 

Helpful treatment hints for vulvar vestibulitis:

*  Vitamin A and D Ointment  How it is used: Apply to the areas of discomfort.
How it Works: Protects the skin, decreases irritation, heals, and soothes.

*  Lidocaine Gel may be prescribed after initial treatment. 
How it is used: Apply lidocaine gel to the vulvovaginal areas of discomfort. 
How it Works: Numbs areas before intercourse.
Caution: After applying, wait until area becomes less sensitive before intercourse. Burning may occur for a short time ( 5 to 10 mins.) after the gel is applied.

*  Witch Hazel Pads (TUCS Pads) How it is used: Apply to the vulvovaginal areas of discomfort. 
How it Works: Decreases burning and irritation after intercourse and urinating.

*  Cleansing Bottle - Pour plain luke-warm water over the vulva after urinating to remove urine from irritated area.  

What is a Vaginal Vault Prolapse?

The vaginal vault is the area at the top of the vagina, next to and adjacent to the cervix. It can only “fall” or descend downwards toward the introitus, or the entrance of the vagina, after a woman's womb has been removed (hysterectomy). Vaginal Vault Prolapse occurs in about 15% of women who have had a hysterectomy for uterine prolapse, and in about 1% of women who have had a hysterectomy for other reasons.

What is Pelvic Organ Prolapse?

Pelvic Organ Prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Organ Prolapse may also be called; genital prolapse, pelvic relaxation, pelvic prolapse, uterine prolapse, uterovaginal prolapse, pelvic floor disorder, urogenital prolapse or vaginal wall prolapse.

What is Pelvic Prolapse?

Pelvic Prolapse is another term used for "pelvic organ prolapse."  Pelvic prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Prolapse may also be called; genital prolapse, pelvic relaxation, uterine prolapse, uterovaginal prolapse, pelvic floor disorder, urogenital prolapse or vaginal wall prolapse.

What is a Prolapsed Uterus?

A Prolapsed Uterus refers to a collapsed uterus, or descended uterus, or other change in the position of the uterus in relation to the surrounding structures within the pelvis. The pelvis contains many soft tissue structures vital to normal body functions, supported primarily by the diaphragms, layers of muscles, fibrous coverings called fasciae, and various ligaments and tendons. These soft tissues of the pelvis derive their ultimate support from the bony pelvis. 

A Prolapsed Uterus may be one of three types, depending on the severity:

• First-degree prolapse occurs when the uterus sags downward into the upper
vagina.

• Second-degree prolapse occurs when the cervix is at or near the outside of the
vagina.

• Third-degree prolapse (sometimes referred to as total prolapse) occurs when the entire uterus extends outside the vagina.

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