311:
conditions. Affected women are also often hesitant to seek treatment for chronic vulvar pain, especially since many women begin experiencing symptoms around the same time they become sexually active. Moreover, the absence of any visible symptoms means that before being successfully diagnosed many patients have been told that the pain is "in their head". The misattribution of women's vulvo-vaginal pain to a psychological origin rather than a medical one is traceable back to the influence of
Freudian
307:
differentiate between generalized and localized pain and delineate the areas of pain and categorize their severity. Patients often will describe the touch of a cotton ball as extremely painful, like the scraping of a knife. A diagram of pain locations may be helpful in assessing the pain over time. The vagina should be examined, and tests, including wet mount, vaginal pH, fungal culture, and Gram stain, should be performed as indicated. Fungal culture may identify resistant strains.
513:(NVA) is a non-profit that helps connect patients to each other and to medical providers who can help them. They maintain a healthcare provider referral list and have geographically-organized patient support groups. The NVA secured the first funding for vulvodynia research in the 1990s, and it continues to provide seed grants for research on vulvodynia.
263:. Initiation of hormonal contraceptives that contain low- dose estrogen before the age of 16 could predispose women to vulvar vestibulitis syndrome. A significantly lower pain threshold, especially in the posterior vestibulum, has also been associated with the use of hormonal contraceptives in women without vulvar vestibulitis syndrome.
497:
The percentage of women affected is not entirely clear, but estimates range between 10-28%. Many other conditions that are not truly vulvodynia (diagnosis is made by ruling out other causes of vulvar pain) could be confused with it. Vulvar pain is a quite frequent complaint in women's health clinics.
519:
is a second, younger community of vulvodynia patients. Founded in 2019, Tight Lipped started as a story-telling podcast focused on ending the stigma and mystery surrounding vulvovaginal pain. It has evolved into a grassroots, patient-led organization devoted to changing how chronic vulvovaginal pain
310:
Surveys have estimated that only about half of the women who meet the criteria for vulvodynia will seek medical help. Many will see several doctors before a correct diagnosis is made. Less than 2% of the people who seek help obtain a diagnosis. Many gynecologists are not familiar with this family of
306:
The condition is one of exclusion and other vulvovaginal problems should be ruled out. The diagnosis is based on the typical complaints of the patient, essentially normal physical findings, and the absence of identifiable causes per the differential diagnosis. Cotton swab testing is used to
67:
The causes of vulvodynia are not fully understood, but there are many sub-types of vulvodynia with different causes, including an excess of nerve fibers, hormonal imbalances, inflammation, and muscular dysfunction. Some factors influencing the disease may include
169:
adhesions, a condition where the hood of the clitoris becomes stuck to the clitoris itself. Symptoms may include pain, hypersenstivity, hyposensitivity, difficulty with arousal, muted or absent orgasm. Clitoral adhesions are common among female patients with
1006:
1650:
1635:
960:
480:
Gynaecologist-led educational seminars delivered in a group format have a significant positive impact on psychological symptoms and sexual functioning in women who have provoked (caused by a stimulus such as touch or sexual activity)
123:
are inserted, or when prolonged pressure is applied to the vulva, such as during sitting, bike riding, or horseback riding. The pain can be provoked by touch ("provoked") or constant ("unprovoked"). Some cases of vulvodynia are
1162:
Haefner, H. K.; Collins, M. E.; Davis, G. D.; Edwards, L; Foster, D. C.; Hartmann, E. D.; Kaufman, R. H.; Lynch, P. J.; Margesson, L. J.; Moyal-Barracco, M; Piper, C. K.; Reed, B. D.; Stewart, E. G.; Wilkinson, E. J. (2005).
653:
Bornstein, J.; Goldstein, A. T.; Stockdale, C. K.; Bergeron, S.; Pukall, C.; Zolnoun, D.; Coady, D. (April 2016). "ISSVD, ISSWSH, and IPPS Consensus
Terminology and Classification of Persistent Vulvar Pain and Vulvodynia".
83:
Treatment may involve a number of different measures; however, as vulvodynia has many sub-types, none is universally effective, and the evidence to support their effectiveness is often poor. Some of these measures include
1728:
193:, has at least three known sub-types: neuroproliferation, hormonally-mediation, and inflammation. Neuroproliferation can be present from birth or acquired later in life. This type of vestibulodynia is known as
506:
Given the difficulty of getting diagnosed and treated for vulvodynia, patients have formed communities to help each other access healthcare and to advocate for better recognition of the disease.
174:, but also occur among the general population. The prevalence of clitoral adhesions is unknown. Clitorodynia has been neglected in medical research and under-recognized in clincical practice.
872:
Bergeron, Sophie; Binik, Yitzchak M.; Khalifé, Samir; Meana, Marta; Berkley, Karen J.; Pagidas, Kelly (1997). "The treatment of vulvar vestibulitis syndrome: Towards a multimodal approach".
1721:
149:
Vestibulodynia is the most common subtype of vulvodynia that affects premenopausal women – the syndrome has been cited as affecting about 10%–15% of women seeking gynecological care.
1714:
433:
Many patients who have vulvodynia also have high-tone pelvic floor, meaning that their pelvic floor muscles are too tight. This may may contribute to their pain in the area.
1032:
Gerber, Stefan; Bongiovanni, Ann Marie; Ledger, William J.; Witkin, Steven S. (2003). "Interleukin-1β gene polymorphism in women with vulvar vestibulitis syndrome".
815:
405:
A number of medications have been used to treat vulvodynia. Evidence to support their use, however, is often poor. These include creams and ointments containing
182:
Vulvodynia has many different sub-types and causes. The disease is highly idiopathic. Identifying the cause is important to determine the appropriate treatment.
1555:
1212:
Reed, Barbara Diane; Harlow, Siobán Denise; Sen, Ananda; Legocki, Laurie Jo; Edwards, Rayna
Monique; Arato, Nora; Haefner, Hope Katharine (February 2012).
378:
377:
In recent years, diagnostic algorithms for the diagnosis of the various sub-types of and causes of vulvar pain have been developed and refined. The
694:
Goldstein, Andrew (2020). Goldstein, Andrew T.; Pukall, Caroline F.; Goldstein, Irwin; Krapf, Jill M.; Goldstein, Sue W.; Goldstein, Gail (eds.).
819:
468:
A number of lifestyle changes are often recommended such as using cotton underwear, not using substances that may irritate the area, and using
713:
108:
Pain is the most notable symptom of vulvodynia, and can be characterized as a burning, stinging, irritation or sharp pain that occurs in the
790:
119:
Symptoms may occur in one place ("localized") or the entire vulvar area ("generalized"). It can occur during or after sexual activity, when
2515:
2550:
2159:
417:. Antidepressants and anticonvulsants in pill form are sometimes tried but have been poorly studied. Injectable medications included
142:
Vestibulodynia, formerly known as vulvar vestibulitis syndrome (VVS), or simply vulvar vestibulitis, refers to pain localized to the
2329:
1848:
1320:"Imperfect Intercourse: Sexual Disability, Sexual Deviance, and the History of Vaginal Pain in the Twentieth-Century United States"
899:
Bergeron, Sophie; Binik, Yitzchak M.; Khalifé, Samir; Pagidas, Kelly (1997). "Vulvar
Vestibulitis Syndrome: A Critical Review".
2545:
2540:
357:
219:. Others include genetic predisposition to inflammation, allergy or other sensitivity (for example: oxalates in the urine), an
386:
1943:
845:
Moyal-Barracco, M; Lynch, P. J. (2004). "2003 ISSVD terminology and classification of vulvodynia: A historical perspective".
337:
434:
89:
456:, and it may be recommended for certain patients. It has been suggested as a first-line treatment for neuroproliferative
116:. It may be constant, intermittent or happen only when the vulva is touched, but vulvodynia usually has a long duration.
740:"Prevalence of symptoms consistent with a diagnosis of vulvodynia: population-based estimates from 2 geographic regions"
255:—including an increased number of nerve endings in the vaginal area. Some cases seem to be negative outcomes of genital
198:
1608:
1494:
Brotto, L. A.; Sadownik, L; Thomson, S (2010). "Impact of educational seminars on women with provoked vestibulodynia".
194:
2456:
510:
738:
Harlow, Bernard; Kunita, Christine; Nguyen, Ruby; Rydell, Sarah; Turner, Rachel; MacLehose, Richard (January 2014).
2451:
2184:
1881:
2500:
2069:
371:
291:
202:
1263:"Women's Experiences of Vulvodynia: An Interpretative Phenomenological Analysis of the Journey Toward Diagnosis"
1836:
1665:
438:
414:
283:
275:
264:
2384:
2334:
2290:
1948:
531:. Because medical knowledge is so hard to access, patients resort to other patients' knowledge to get help.
460:. It has successful long-term outcomes, but is often only offered after conservative measures have failed.
325:
1411:"Vulvar Vestibulectomy for Neuroproliferative-Associated Provoked Vestibulodynia: A Retrospective Analysis"
2362:
1938:
1777:
1737:
2367:
2221:
2164:
2089:
2027:
1888:
279:
472:
during sex. The use of alternative medicine has not been sufficiently studied to make recommendations.
1067:
Basson, Rosemary; Weijmar
Schultz, Willibrord (2007). "Sexual sequelae of general medical disorders".
823:
80:. Diagnosis is by ruling out other possible causes. This may or may not include a biopsy of the area.
2379:
1804:
248:
244:
2490:
2429:
2285:
1654:
1261:
Shallcross, Rebekah; Dickson, Joanne M.; Nunns, David; Taylor, Kate; Kiemle, Gundi (1 April 2019).
397:
There are a number of possible treatments with none being uniformly effective. Treatments include:
240:
224:
220:
209:
516:
162:
2357:
2314:
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2216:
2179:
2084:
2034:
2017:
1985:
1975:
1876:
1831:
1787:
1782:
1194:
1092:
695:
635:
548:
Feldhaus-Dahir, M (2011). "The causes and prevalence of vestibulodynia: A vulvar pain disorder".
469:
57:
60:. Symptoms typically include a feeling of burning or irritation. It has been established by the
1007:"News: Half the World Has a Clitoris. Why... (The New York Times) - Behind the headlines - NLM"
146:
region. It tends to be associated with a highly localized "burning" or "cutting" type of pain.
2372:
2270:
1953:
1841:
1511:
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1300:
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213:
32:
1706:
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2495:
2424:
2226:
2054:
1821:
1760:
1503:
1468:
1457:"Evaluation of Long-Term Surgical Success and Satisfaction of Patients After Vestibulectomy"
1422:
1381:
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1331:
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1274:
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1041:
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77:
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2000:
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236:
216:
1319:
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2191:
2169:
2005:
1868:
1853:
1797:
1386:
1361:
1357:
1295:
1262:
1238:
1214:"Prevalence and demographic characteristics of vulvodynia in a population-based sample"
1213:
764:
739:
482:
457:
449:
312:
190:
137:
1659:
1507:
1409:
King, Michelle A.; Mitchell, Leia S.; Belkin, Zoe; Goldstein, Andrew T. (April 2018).
1080:
1045:
2555:
2534:
2485:
2010:
1995:
1958:
1893:
1811:
1181:
1164:
912:
351:
287:
1198:
1096:
2404:
2257:
2136:
2044:
2022:
1963:
1898:
1826:
1741:
561:
520:
conditions like vulvodynia are understood by the medical community and by society.
271:
49:
639:
1670:
1472:
623:
2409:
2324:
2297:
2261:
2207:
2128:
2113:
2039:
1926:
1903:
1792:
329:
260:
97:
1229:
755:
667:
2394:
2344:
2266:
2174:
2105:
1990:
1816:
1689:
1377:
1278:
885:
252:
85:
73:
37:
1434:
1335:
1286:
1111:
976:
2399:
2389:
2275:
1745:
1639:
959:
Romanello, Jennifer; Myers, Monica; Nico, Elsa; Rubin, Rachel (March 2023).
610:
Stockdale, C. K.; Lawson, H. W. (2014). "2013 Vulvodynia
Guideline update".
406:
367:
341:
125:
64:
that for the diagnosis to be made symptoms must last at least three months.
1515:
1480:
1395:
1360:; Swamy, Sheela; Gill, Kiren; Kupelian, Anthony; Malone-Lee, James (2018).
1304:
1247:
1190:
1148:
1088:
1053:
984:
858:
773:
675:
631:
569:
441:
and help the patient gain greater control over their pelvic floor muscles.
1426:
934:
920:
705:
2505:
2211:
1694:
1556:"Painful sex? Broken vaginas? This underground zine normalizes the taboo"
524:
410:
166:
158:
69:
1627:
1034:
European
Journal of Obstetrics & Gynecology and Reproductive Biology
418:
295:
270:
Many co-morbidities are commonly associated with vulvodynia, including
256:
120:
93:
2146:
1917:
1612:
528:
333:
228:
113:
1112:"Differential Diagnosis of Pelvic Floor Dysfunction and Vulvar Pain"
109:
61:
53:
1710:
1580:
523:
There are several online communities of patients on sites like
201:
can be caused by hormonal medications like oral birth control.
1362:"Lower urinary tract symptoms that predict microscopic pyuria"
1135:
Hill, DA; Taylor, CA (15 May 2021). "Dyspareunia in Women".
379:
International
Society for the Study of Women's Sexual Health
100:. Vulvodynia is estimated to affect up to 10-28% of women.
1529:
697:
Female Sexual Pain
Disorders: Evaluation and Management
1617:
2476:
2469:
2444:
2311:
2244:
2200:
2145:
2127:
2104:
1972:
1925:
1916:
1867:
1768:
1759:
1752:
1680:
1621:
795:
American
College of Obstetricians and Gynecologists
31:
26:
267:may be the underlying cause of some women's pain.
961:"Clitoral adhesions: a review of the literature"
370:secondary to herpes virus, spinal nerve injury,
816:National Research Center for Women and Families
1455:Arik, David; Bornstein, Jacob (October 2020).
1722:
1218:American Journal of Obstetrics and Gynecology
744:American Journal of Obstetrics and Gynecology
8:
1496:Journal of Obstetrics and Gynaecology Canada
1130:
1128:
605:
603:
601:
599:
597:
595:
593:
591:
589:
587:
585:
583:
581:
579:
205:can develop as part of an immune response.
157:The pain of vulvodynia may extend into the
128:where no specific cause can be determined.
2473:
2250:
1931:
1922:
1765:
1756:
1729:
1715:
1707:
1618:
165:. Clitorodynia may be sometimes caused by
23:
1385:
1294:
1237:
1180:
763:
1356:Khasriya, Rajvinder; Barcella, William;
733:
731:
729:
727:
725:
689:
687:
685:
16:Chronic pain syndrome of the vulvar area
540:
1461:Journal of Lower Genital Tract Disease
1169:Journal of Lower Genital Tract Disease
612:Journal of Lower Genital Tract Disease
425:have been tried with limited success.
7:
847:The Journal of Reproductive Medicine
785:
783:
2516:Persistent genital arousal disorder
1366:International Urogynecology Journal
939:The National Vulvodynia Association
199:Hormonally-mediated vestibulodynia
14:
2330:Hypoactive sexual desire disorder
1849:Ovarian hyperstimulation syndrome
1110:Kellogg-Spadt, S (October 2003).
195:neuroproliferative vestibulodynia
1182:10.1097/00128360-200501000-00009
913:10.1097/00002508-199703000-00006
700:(2 ed.). pp. 157–162.
212:, the symptoms of which include
1534:National Vulvodynia Association
511:National Vulvodynia Association
1944:Dysfunctional uterine bleeding
1415:Journal of Gynecologic Surgery
1005:Gross, Rachel (October 2022).
562:10.7257/1053-816X.2012.31.1.51
208:Other possible causes include
1:
1508:10.1016/s1701-2163(16)34427-9
1318:Srajer, Hannah (March 2023).
1081:10.1016/S0140-6736(07)60197-4
1046:10.1016/S0301-2115(02)00276-2
820:"Vulvodynia and Genital Pain"
435:Pelvic floor physical therapy
90:pelvic floor physical therapy
2040:Menorrhagia (hypermenorrhea)
2011:Polymenorrhea (epimenorrhea)
1473:10.1097/LGT.0000000000000552
901:The Clinical Journal of Pain
624:10.1097/LGT.0000000000000021
2457:Pelvic inflammatory disease
1324:Journal of American History
1267:Archives of Sexual Behavior
452:is a surgery to remove the
203:Inflammatory vestibulodynia
56:area and occurs without an
52:condition that affects the
2572:
2452:Pelvic congestion syndrome
1882:Fallopian tube obstruction
1230:10.1016/j.ajog.2011.08.012
1165:"The vulvodynia guideline"
874:Sexual and Marital Therapy
756:10.1016/j.ajog.2013.09.033
668:10.1016/j.jsxm.2016.02.167
135:
2551:Neurocutaneous conditions
2501:Vestibular papillomatosis
2420:
2353:
2253:
2080:
2070:Metropathia haemorrhagica
1934:
1378:10.1007/s00192-017-3472-7
1279:10.1007/s10508-018-1246-z
1137:American Family Physician
886:10.1080/02674659708408174
415:tricyclic antidepressants
372:pudendal nerve entrapment
346:Dermetological diseases:
161:; this is referred to as
1837:Follicular cyst of ovary
791:"Persistent Vulvar Pain"
439:pelvic floor dysfunction
284:pelvic floor dysfunction
276:irritable bowel syndrome
265:Pelvic floor dysfunction
2335:Sexual arousal disorder
2291:Candidal vulvovaginitis
1949:Endometrial hyperplasia
965:Sexual Medicine Reviews
485:(pain localized in the
326:urinary tract infection
2546:Gynaecologic disorders
2541:Chronic pain syndromes
1778:Endometriosis of ovary
1336:10.1093/jahist/jaad001
977:10.1093/sxmrev/qead004
319:Differential diagnosis
2222:Vesicouterine fistula
2165:Cervical incompetence
2090:Recurrent miscarriage
2028:Premenstrual syndrome
1889:Fallopian tube cancer
1427:10.1089/gyn.2017.0030
935:"What is Vulvodynia?"
706:10.1002/9781119482598
509:Founded in 1994, the
366:Neurologic disorder:
280:interstitial cystitis
185:Pain confined to the
2380:Rectovaginal fistula
1805:Poor ovarian reserve
1224:(2): 170.e1–170.e9.
1013:. The New York Times
387:diagnostic algorithm
112:and entrance to the
2430:Postcoital bleeding
2358:Urogenital fistulas
2286:Bacterial vaginosis
1939:Asherman's syndrome
502:Patient communities
437:may help treat the
241:bacterial vaginosis
235:, infection (e.g.,
225:lupus erythematosus
221:autoimmune disorder
2315:Sexual dysfunction
2281:Atrophic vaginitis
2217:Retroverted uterus
2180:Female infertility
2160:Cervical dysplasia
2085:Female infertility
1877:Female infertility
1832:Corpus luteum cyst
1788:Ovulatory disorder
1783:Female infertility
1681:External resources
104:Signs and symptoms
58:identifiable cause
2528:
2527:
2524:
2523:
2465:
2464:
2440:
2439:
2373:Obstetric fistula
2271:Vaginal discharge
2240:
2239:
2185:Cervical stenosis
2100:
2099:
1954:Endometrial polyp
1912:
1911:
1842:Theca lutein cyst
1704:
1703:
1560:Los Angeles times
1075:(9559): 409–424.
715:978-1-119-48266-6
296:anxiety disorders
43:
42:
21:Medical condition
2563:
2496:Kraurosis vulvae
2491:Bartholin's cyst
2474:
2425:Vaginal bleeding
2318:
2251:
2227:Uterine prolapse
2055:Menometrorrhagia
1979:
1932:
1923:
1822:Ovarian apoplexy
1766:
1757:
1731:
1724:
1717:
1708:
1619:
1596:
1595:
1593:
1591:
1577:
1571:
1570:
1568:
1566:
1551:
1545:
1544:
1542:
1540:
1526:
1520:
1519:
1491:
1485:
1484:
1452:
1446:
1445:
1443:
1441:
1406:
1400:
1399:
1389:
1372:(7): 1019–1028.
1353:
1347:
1346:
1344:
1342:
1315:
1309:
1308:
1298:
1258:
1252:
1251:
1241:
1209:
1203:
1202:
1184:
1159:
1153:
1152:
1132:
1123:
1122:
1120:
1118:
1107:
1101:
1100:
1064:
1058:
1057:
1029:
1023:
1022:
1020:
1018:
1002:
996:
995:
993:
991:
956:
950:
949:
947:
945:
931:
925:
924:
896:
890:
889:
869:
863:
862:
842:
836:
835:
833:
831:
822:. Archived from
818:(October 2007).
812:
806:
805:
803:
801:
787:
778:
777:
767:
735:
720:
719:
691:
680:
679:
650:
644:
643:
607:
574:
573:
550:Urologic Nursing
545:
487:vulvar vestibule
454:vulval vestibule
429:Physical therapy
385:) supports this
362:vulvar carcinoma
348:lichen sclerosus
237:yeast infections
233:lichen sclerosus
210:Sjögren syndrome
187:vulval vestibule
172:lichen sclerosus
24:
2571:
2570:
2566:
2565:
2564:
2562:
2561:
2560:
2531:
2530:
2529:
2520:
2461:
2436:
2416:
2349:
2312:
2307:
2303:Vaginal atresia
2236:
2196:
2155:Cervical cancer
2141:
2123:
2119:Uterine fibroid
2096:
2076:
2060:Polymenorrhagia
2001:Oligoamenorrhea
1973:
1968:
1908:
1863:
1859:Ovarian torsion
1748:
1738:Female diseases
1735:
1705:
1700:
1699:
1676:
1675:
1630:
1605:
1600:
1599:
1589:
1587:
1579:
1578:
1574:
1564:
1562:
1554:Brown, Kailyn.
1553:
1552:
1548:
1538:
1536:
1528:
1527:
1523:
1493:
1492:
1488:
1454:
1453:
1449:
1439:
1437:
1408:
1407:
1403:
1358:De Iorio, Maria
1355:
1354:
1350:
1340:
1338:
1317:
1316:
1312:
1260:
1259:
1255:
1211:
1210:
1206:
1161:
1160:
1156:
1143:(10): 597–604.
1134:
1133:
1126:
1116:
1114:
1109:
1108:
1104:
1066:
1065:
1061:
1031:
1030:
1026:
1016:
1014:
1004:
1003:
999:
989:
987:
958:
957:
953:
943:
941:
933:
932:
928:
898:
897:
893:
871:
870:
866:
844:
843:
839:
829:
827:
826:on 25 July 2011
814:
813:
809:
799:
797:
789:
788:
781:
737:
736:
723:
716:
693:
692:
683:
652:
651:
647:
609:
608:
577:
547:
546:
542:
537:
504:
495:
478:
466:
447:
431:
423:botulinum toxin
403:
395:
358:Paget's disease
321:
304:
251:), injury, and
217:vaginal dryness
180:
155:
140:
134:
106:
76:, and possibly
22:
17:
12:
11:
5:
2569:
2567:
2559:
2558:
2553:
2548:
2543:
2533:
2532:
2526:
2525:
2522:
2521:
2519:
2518:
2513:
2508:
2503:
2498:
2493:
2488:
2482:
2480:
2471:
2467:
2466:
2463:
2462:
2460:
2459:
2454:
2448:
2446:
2442:
2441:
2438:
2437:
2435:
2434:
2433:
2432:
2421:
2418:
2417:
2415:
2414:
2413:
2412:
2407:
2402:
2397:
2392:
2382:
2377:
2376:
2375:
2370:
2365:
2363:Ureterovaginal
2354:
2351:
2350:
2348:
2347:
2342:
2340:Vaginal cancer
2337:
2332:
2327:
2321:
2319:
2309:
2308:
2306:
2305:
2300:
2295:
2294:
2293:
2288:
2283:
2273:
2264:
2254:
2248:
2242:
2241:
2238:
2237:
2235:
2234:
2232:Uterine cancer
2229:
2224:
2219:
2214:
2204:
2202:
2198:
2197:
2195:
2194:
2192:Nabothian cyst
2189:
2188:
2187:
2177:
2172:
2170:Cervical polyp
2167:
2162:
2157:
2151:
2149:
2143:
2142:
2140:
2139:
2133:
2131:
2125:
2124:
2122:
2121:
2116:
2110:
2108:
2102:
2101:
2098:
2097:
2095:
2094:
2093:
2092:
2081:
2078:
2077:
2075:
2074:
2073:
2072:
2064:
2063:
2062:
2057:
2049:
2048:
2047:
2042:
2032:
2031:
2030:
2025:
2015:
2014:
2013:
2008:
2006:Oligomenorrhea
2003:
1998:
1993:
1982:
1980:
1970:
1969:
1967:
1966:
1961:
1956:
1951:
1946:
1941:
1935:
1929:
1920:
1914:
1913:
1910:
1909:
1907:
1906:
1901:
1896:
1891:
1886:
1885:
1884:
1873:
1871:
1869:Fallopian tube
1865:
1864:
1862:
1861:
1856:
1854:Ovarian cancer
1851:
1846:
1845:
1844:
1839:
1834:
1824:
1819:
1814:
1809:
1808:
1807:
1802:
1801:
1800:
1798:Oligoovulation
1795:
1780:
1774:
1772:
1763:
1754:
1750:
1749:
1736:
1734:
1733:
1726:
1719:
1711:
1702:
1701:
1698:
1697:
1685:
1684:
1682:
1678:
1677:
1674:
1673:
1662:
1647:
1631:
1626:
1625:
1623:
1622:Classification
1616:
1615:
1604:
1603:External links
1601:
1598:
1597:
1581:"Tight Lipped"
1572:
1546:
1521:
1486:
1467:(4): 399–404.
1447:
1401:
1348:
1330:(4): 782–803.
1310:
1273:(3): 961–974.
1253:
1204:
1154:
1124:
1102:
1059:
1024:
997:
971:(3): 196–201.
951:
926:
891:
880:(4): 305–311.
864:
837:
807:
779:
750:(1): 40.e1–8.
721:
714:
681:
645:
575:
539:
538:
536:
533:
503:
500:
494:
491:
483:vestibulodynia
477:
474:
465:
462:
458:vestibulodynia
450:Vestibulectomy
446:
443:
430:
427:
402:
399:
394:
391:
375:
374:
364:
354:
344:
320:
317:
313:psychoanalysis
303:
300:
191:vestibulodynia
179:
176:
154:
151:
138:Vestibulodynia
136:Main article:
133:
132:Vestibulodynia
130:
105:
102:
41:
40:
35:
29:
28:
20:
15:
13:
10:
9:
6:
4:
3:
2:
2568:
2557:
2554:
2552:
2549:
2547:
2544:
2542:
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2538:
2536:
2517:
2514:
2512:
2509:
2507:
2504:
2502:
2499:
2497:
2494:
2492:
2489:
2487:
2486:Vulvar cancer
2484:
2483:
2481:
2479:
2475:
2472:
2468:
2458:
2455:
2453:
2450:
2449:
2447:
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2426:
2423:
2422:
2419:
2411:
2408:
2406:
2403:
2401:
2398:
2396:
2393:
2391:
2388:
2387:
2386:
2383:
2381:
2378:
2374:
2371:
2369:
2368:Vesicovaginal
2366:
2364:
2361:
2360:
2359:
2356:
2355:
2352:
2346:
2343:
2341:
2338:
2336:
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2328:
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2322:
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2259:
2256:
2255:
2252:
2249:
2247:
2243:
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2230:
2228:
2225:
2223:
2220:
2218:
2215:
2213:
2209:
2206:
2205:
2203:
2199:
2193:
2190:
2186:
2183:
2182:
2181:
2178:
2176:
2173:
2171:
2168:
2166:
2163:
2161:
2158:
2156:
2153:
2152:
2150:
2148:
2144:
2138:
2135:
2134:
2132:
2130:
2126:
2120:
2117:
2115:
2112:
2111:
2109:
2107:
2103:
2091:
2088:
2087:
2086:
2083:
2082:
2079:
2071:
2068:
2067:
2065:
2061:
2058:
2056:
2053:
2052:
2050:
2046:
2043:
2041:
2038:
2037:
2036:
2033:
2029:
2026:
2024:
2021:
2020:
2019:
2016:
2012:
2009:
2007:
2004:
2002:
1999:
1997:
1996:Hypomenorrhea
1994:
1992:
1989:
1988:
1987:
1984:
1983:
1981:
1978:
1977:
1971:
1965:
1962:
1960:
1959:Endometriosis
1957:
1955:
1952:
1950:
1947:
1945:
1942:
1940:
1937:
1936:
1933:
1930:
1928:
1924:
1921:
1919:
1915:
1905:
1902:
1900:
1897:
1895:
1894:Hematosalpinx
1892:
1890:
1887:
1883:
1880:
1879:
1878:
1875:
1874:
1872:
1870:
1866:
1860:
1857:
1855:
1852:
1850:
1847:
1843:
1840:
1838:
1835:
1833:
1830:
1829:
1828:
1825:
1823:
1820:
1818:
1815:
1813:
1812:Mittelschmerz
1810:
1806:
1803:
1799:
1796:
1794:
1791:
1790:
1789:
1786:
1785:
1784:
1781:
1779:
1776:
1775:
1773:
1771:
1767:
1764:
1762:
1758:
1755:
1751:
1747:
1743:
1739:
1732:
1727:
1725:
1720:
1718:
1713:
1712:
1709:
1696:
1692:
1691:
1687:
1686:
1683:
1679:
1672:
1668:
1667:
1663:
1661:
1657:
1656:
1652:
1648:
1646:
1642:
1641:
1637:
1633:
1632:
1629:
1624:
1620:
1614:
1610:
1607:
1606:
1602:
1586:
1582:
1576:
1573:
1561:
1557:
1550:
1547:
1535:
1531:
1525:
1522:
1517:
1513:
1509:
1505:
1501:
1497:
1490:
1487:
1482:
1478:
1474:
1470:
1466:
1462:
1458:
1451:
1448:
1436:
1432:
1428:
1424:
1420:
1416:
1412:
1405:
1402:
1397:
1393:
1388:
1383:
1379:
1375:
1371:
1367:
1363:
1359:
1352:
1349:
1337:
1333:
1329:
1325:
1321:
1314:
1311:
1306:
1302:
1297:
1292:
1288:
1284:
1280:
1276:
1272:
1268:
1264:
1257:
1254:
1249:
1245:
1240:
1235:
1231:
1227:
1223:
1219:
1215:
1208:
1205:
1200:
1196:
1192:
1188:
1183:
1178:
1174:
1170:
1166:
1158:
1155:
1150:
1146:
1142:
1138:
1131:
1129:
1125:
1113:
1106:
1103:
1098:
1094:
1090:
1086:
1082:
1078:
1074:
1070:
1063:
1060:
1055:
1051:
1047:
1043:
1039:
1035:
1028:
1025:
1012:
1008:
1001:
998:
986:
982:
978:
974:
970:
966:
962:
955:
952:
940:
936:
930:
927:
922:
918:
914:
910:
906:
902:
895:
892:
887:
883:
879:
875:
868:
865:
860:
856:
853:(10): 772–7.
852:
848:
841:
838:
825:
821:
817:
811:
808:
796:
792:
786:
784:
780:
775:
771:
766:
761:
757:
753:
749:
745:
741:
734:
732:
730:
728:
726:
722:
717:
711:
707:
703:
699:
698:
690:
688:
686:
682:
677:
673:
669:
665:
662:(4): 607–12.
661:
657:
649:
646:
641:
637:
633:
629:
625:
621:
618:(2): 93–100.
617:
613:
606:
604:
602:
600:
598:
596:
594:
592:
590:
588:
586:
584:
582:
580:
576:
571:
567:
563:
559:
555:
551:
544:
541:
534:
532:
530:
526:
521:
518:
514:
512:
507:
501:
499:
492:
490:
488:
484:
475:
473:
471:
463:
461:
459:
455:
451:
444:
442:
440:
436:
428:
426:
424:
420:
416:
412:
408:
400:
398:
392:
390:
388:
384:
380:
373:
369:
365:
363:
359:
355:
353:
352:lichen planus
349:
345:
343:
339:
335:
331:
327:
323:
322:
318:
316:
314:
308:
301:
299:
297:
293:
289:
288:endometriosis
285:
281:
277:
273:
268:
266:
262:
258:
254:
250:
246:
242:
238:
234:
230:
226:
222:
218:
215:
211:
206:
204:
200:
196:
192:
188:
183:
177:
175:
173:
168:
164:
160:
152:
150:
147:
145:
139:
131:
129:
127:
122:
117:
115:
111:
103:
101:
99:
95:
91:
87:
81:
79:
75:
71:
65:
63:
59:
55:
51:
47:
39:
36:
34:
30:
25:
19:
2510:
2405:Sigmoidocele
2313:
2258:Hematocolpos
2137:Parametritis
2045:Metrorrhagia
2023:Dysmenorrhea
1976:Menstruation
1974:
1964:Endometritis
1899:Hydrosalpinx
1827:Ovarian cyst
1688:
1664:
1649:
1634:
1588:. Retrieved
1585:Tight Lipped
1584:
1575:
1563:. Retrieved
1559:
1549:
1537:. Retrieved
1533:
1524:
1502:(2): 132–8.
1499:
1495:
1489:
1464:
1460:
1450:
1438:. Retrieved
1421:(2): 58–62.
1418:
1414:
1404:
1369:
1365:
1351:
1339:. Retrieved
1327:
1323:
1313:
1270:
1266:
1256:
1221:
1217:
1207:
1175:(1): 40–51.
1172:
1168:
1157:
1140:
1136:
1117:11 September
1115:. Retrieved
1105:
1072:
1068:
1062:
1040:(1): 74–77.
1037:
1033:
1027:
1015:. Retrieved
1010:
1000:
988:. Retrieved
968:
964:
954:
942:. Retrieved
938:
929:
907:(1): 27–42.
904:
900:
894:
877:
873:
867:
850:
846:
840:
828:. Retrieved
824:the original
810:
798:. Retrieved
794:
747:
743:
696:
659:
655:
648:
615:
611:
553:
549:
543:
522:
517:Tight Lipped
515:
508:
505:
496:
493:Epidemiology
479:
467:
448:
432:
404:
396:
376:
324:Infections:
309:
305:
272:fibromyalgia
269:
259:, such as a
207:
184:
181:
163:clitorodynia
156:
153:Clitorodynia
148:
141:
118:
107:
82:
66:
50:chronic pain
45:
44:
18:
2410:Urethrocele
2325:Dyspareunia
2298:Hydrocolpos
2262:Hydrocolpos
2208:Hematometra
2129:Parametrium
2114:Adenomyosis
1927:Endometrium
1904:Salpingitis
1793:Anovulation
556:(1): 51–4.
401:Medications
330:candidiasis
261:labioplasty
223:similar to
189:, known as
98:counselling
86:medications
2535:Categories
2511:Vulvodynia
2395:Enterocele
2345:Vaginismus
2267:Leukorrhea
2175:Cervicitis
2106:Myometrium
1991:Amenorrhea
1817:Oophoritis
1695:Vulvodynia
1690:Patient UK
1609:Vulvodynia
1069:The Lancet
944:29 January
800:30 October
535:References
476:Counseling
356:Neoplasm:
292:depression
253:neuropathy
144:vestibular
126:idiopathic
74:immunology
46:Vulvodynia
38:Gynecology
27:Vulvodynia
2400:Rectocele
2390:Cystocele
2276:Vaginitis
1435:1042-4067
1287:1573-2800
830:27 August
656:J Sex Med
470:lubricant
464:Lifestyle
407:lidocaine
393:Treatment
368:neuralgia
342:vaginitis
302:Diagnosis
33:Specialty
2506:Vulvitis
2470:External
2385:Prolapse
2212:Pyometra
1753:Internal
1746:genitals
1590:29 March
1565:29 March
1539:29 March
1516:20181314
1481:32569021
1440:29 March
1396:28971220
1341:29 March
1305:30047005
1248:21963307
1199:18081230
1191:15870521
1149:33983001
1097:44628975
1089:17276781
1054:12593899
1017:29 March
990:29 March
985:36973166
859:15568398
774:24080300
676:27045260
632:24633161
570:21542444
525:Facebook
419:steroids
411:estrogen
167:clitoris
159:clitoris
70:genetics
2201:General
1740:of the
1671:D056650
1387:6004270
1296:6418055
1239:3779055
921:9084950
765:3885163
445:Surgery
257:surgery
214:chronic
121:tampons
94:surgery
2246:Vagina
2147:Cervix
2066:Other
2051:Mixed
2035:Timing
1918:Uterus
1761:Adnexa
1742:pelvis
1645:N94.81
1613:Curlie
1514:
1479:
1433:
1394:
1384:
1303:
1293:
1285:
1246:
1236:
1197:
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1147:
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1052:
983:
919:
857:
772:
762:
712:
674:
640:410660
638:
630:
568:
529:Reddit
383:ISSWSH
334:herpes
231:or to
229:eczema
227:or to
178:Causes
114:vagina
96:, and
54:vulvar
2478:Vulva
2445:Other
1770:Ovary
1660:625.7
1640:10-CM
1530:"NVA"
1195:S2CID
1093:S2CID
636:S2CID
110:vulva
62:ISSVD
48:is a
2556:Pain
2018:Pain
1986:Flow
1744:and
1666:MeSH
1655:9-CM
1592:2024
1567:2024
1541:2024
1512:PMID
1477:PMID
1442:2024
1431:ISSN
1392:PMID
1343:2024
1301:PMID
1283:ISSN
1244:PMID
1187:PMID
1145:PMID
1119:2012
1085:PMID
1050:PMID
1019:2024
1011:NCBI
992:2024
981:PMID
946:2019
917:PMID
855:PMID
832:2009
802:2020
770:PMID
710:ISBN
672:PMID
628:PMID
566:PMID
527:and
421:and
294:and
78:diet
1651:ICD
1636:ICD
1611:at
1504:doi
1469:doi
1423:doi
1382:PMC
1374:doi
1332:doi
1328:109
1291:PMC
1275:doi
1234:PMC
1226:doi
1222:206
1177:doi
1141:103
1077:doi
1073:369
1042:doi
1038:107
973:doi
909:doi
882:doi
760:PMC
752:doi
748:210
702:doi
664:doi
620:doi
558:doi
489:).
413:or
338:HPV
249:HSV
245:HPV
2537::
2269:/
2260:/
2210:/
1693::
1669::
1658::
1643::
1583:.
1558:.
1532:.
1510:.
1500:32
1498:.
1475:.
1465:24
1463:.
1459:.
1429:.
1419:34
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1390:.
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1370:29
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1271:48
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1242:.
1232:.
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1193:.
1185:.
1171:.
1167:.
1139:.
1127:^
1091:.
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969:11
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851:49
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660:13
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616:18
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578:^
564:.
554:31
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