[3] Vestibulodynia is characterized by severe pain with attempted penetration of the vaginal orifice and reports of tenderness with pressure within the vulval vestibule.
Many people with vulvovaginal pain experience of chronic frustration, disappointment, hopelessness and depression because of the impacts that the disease has on their lives.
It can negatively impact a person's quality of life, their romantic and sexual relationships, and their ability to participant in normal activities.
Neuroproliferative vestibulodynia is a disease where in there are an excess of pain receptors (C-afferent nociceptors) and mast cells in the vestibule.
[8] Others develop neuroproliferation later in life (acquired neuroproliferative vestibulodynia), perhaps as part of an immune response to infection or allergy.
[9] Labs may show high sex hormone binding globulin or low free testosterone.
[10] The International Society for the Study of Women's Sexual Health (ISSWSH) supports this diagnostic algorithm.
[12] Diagnosis is made by the q-tip cotton-swab test, in which pressure is applied in a circular fashion around the vulvar vestibule to assess complaints of pain.
For congenital neuroproliferative vestibulodynia, the gold-standard treatment is a surgery to remove the vestibule, called vestibulectomy.
Treatment typically requires a multidisciplinary team including a gynecologist, a pelvic floor physical therapist, sometimes a surgeon, and sometimes a counsellor to help patients navigate the psychosocial burdens of the condition.