Vulvitis, an inflammation of the vulva, may occur with other dis-orders, such as diabetes, dermatologic problems, or poor hygiene, or it may be secondary to irritation from a vaginal discharge re-lated to a specific vaginitis.
Vulvodynia is a chronic syndrome of vulvar discomfort.Symptoms may include burning, stinging, irritation or excoria-tion. It has been described as primary, with onset at first tampon insertion or sexual experience, or secondary, beginning months or years after first tampon insertion or sexual experience. It may be classified as organic if it has a known cause (infection, trauma, or irritants) or idiopathic if no cause is known. It seems to be sim-ilar to a peripheral neuralgia and may respond to treatment with tricyclic antidepressants.
Cyclic vulvitis is a subset of vulvodynia and is characterized by episodes of vulvar discomfort. Typical complaints are recurrent itching and burning, often worsening with menses and after sex-ual intercourse. Erythema and swelling may occur. It is often re-lated to candidal infection, and fungal cultures are often positive.
Vulvar vestibulitis is a chronic persistent syndrome of severe pain on touch to the vestibular area or attempted vaginal entry, and physical findings of vestibular erythema. Treatment methods vary. Research is ongoing to identify treatment for vulvar vestibulitis, but topical treatments (ie, estrogens, corticosteroids, trichloroacetic acid), surgery, and interferon have been used. Biofeedback has also been used.
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