Vulvar vestibulitis steroid cream

Of all surgical procedures used, a vestibulectomy with vaginal advancement appears to be the most effective, with significant success rates for patients with vulvar vestibulitis syndrome. Appropriate patient selection for surgical procedures is critical to a successful outcome. Some physicians have also reported successful outcomes using a modified surgical procedure, involving the removal of small, painful areas, rather than the entire vestibule. A detailed description of how a vestibulectomy with vaginal advancement is performed, including diagrams and actual photos from surgical patients, can be viewed online. (1139 KB)

Little is known about the cause of vestibulodynia. A number of causes may be involved, including sub-clinical human papillomavirus infection, chronic recurrent candidiasis , or chronic recurrent bacterial vaginosis . [2] [3] Muscular causes have been implicated as well, since chronic vulvar pain may be the result of chronic hypertonic perivaginal muscles, leading to vaginal tightening and subsequent pain. Some investigators have postulated the existence of neurological causes, such as vestibular neural hyperplasia . Finally, psychological factors may contribute to or exacerbate the problem, since the anticipation of pain often results in a conditioned spasmodic reflex along with sexual desire and arousal problems.

Irregular hormonal changes can also play into chronic infections. The healthy vagina contains a balance of different types of bacteria, and different hormonal environments can allow the overgrowths of some types. Vaginal discharge becomes alkaline at ovulation, which can result in burning -- and the presence of semen may cause the same effect. Progesterone increases prior to menstruation can allow an overgrowth of lactobacilli, which can result in a painfully acidic feeling; yeast may flourish during menstruation; and low estrogen after menstruation may cause drying and cracking. The key to symptom treatment in this case is awareness of which of these components is active at any time, given where you are in your cycle. For instance, baking soda and water douches may help with lactobacillus overgrowth; boric acid may help during menstruation; lubricating ointments may help post-period.

There is much ongoing research into the cause and treatment of LPV and also on the emotional toll on women who have chronic vulvar pain and who may not be able to enjoy some forms of sexual activity. It is important to continue to be intimate with a partner during treatment in ways that are comfortable for both partners; counseling can be a great help to women and their partners as they work through issues relating to sexuality and relationships. There are support groups available, and the National Vulvodynia Association website, ,  is a great place to find information on vulvodynia, including current research, conferences and publications.

Vulvar vestibulitis steroid cream

vulvar vestibulitis steroid cream

There is much ongoing research into the cause and treatment of LPV and also on the emotional toll on women who have chronic vulvar pain and who may not be able to enjoy some forms of sexual activity. It is important to continue to be intimate with a partner during treatment in ways that are comfortable for both partners; counseling can be a great help to women and their partners as they work through issues relating to sexuality and relationships. There are support groups available, and the National Vulvodynia Association website, ,  is a great place to find information on vulvodynia, including current research, conferences and publications.

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