A review on vulval pain syndromes

Abstract

The vulval pain syndromes are enigmatic causes of vulval pain. Although not new conditions, only since the mid-1980s have the clinical descriptions of these women have been standardised. In 1991 the term vulvodynia and its subsets were introduced by the International Society for the Study of Vulval Diseases (ISSVD) to describe women with chronic vulval discomfort characterised by burning, stinging, rawness or irritation. The terminology is potentially confusing as vulvodynia was originally described as having subsets including both infective and dermatological diagnoses. These included vulval dermatoses (e.g. lichen sclerosus), vulval vestibulitis, vestibular papillomatosis, dysaesthetic (formerly essential vulvodynia) and cyclical vulvitis. This review article focuses on vulval vestibulitis and dysaesthetic vulvodynia as these relate to vulval pain when infection and organic causes have been excluded and together form the vulval pain syndromes. Recent interest in these pain syndromes probably relates to an increasing number of patients attending vulval clinics, patients’ demands and general increased awareness amongst women and health professionals.