Vulvar Vestibulitis Syndrome (VVS)

Vulvar vestibulitis is a common form of vulvodynia that has been described as one of the most common causes of genital and sexual pain in women, affecting upwards of 15% [Gardella, 2006]. VVS is specific to pain on touch and/or pressure only in the vestibule. The vulvar vestibule is the area within the inner lips surrounding the vaginal opening. VVS is typically diagnosed using Friedrich's Criteria [Friedrich, 1987] which is:

  1. Severe pain in the vulvar vestibule upon touch or attempted vaginal entry
  2. Tenderness to pressure localized within the vulvar vestibule
  3. Vulvar erythema (inflammation) of various degrees

For diagnosis, a cotton-swab is typically used to place gentle pressure in the vestibule. If VVS is present, the cotton-swab test will often elicit severe pain or discomfort from the woman.

Like other pain causing conditions, any form of VVS may cause or contribute to problems with vaginismus and/or may coexist with vaginismus on an ongoing basis. As a result, women may need to address both conditions before they are able to fully restore fully pain-free intercourse.

Medical Articles/Studies

  1. Bergeron, S., Binik, Y.M., Khalife, S., Pagidas, K., Glazer, H. (2001). Vulvar vestibulitis syndrome: Reliability of diagnosis and evaluation of current diagnostic criteria. Obstet Gynecol, 98(1), 45-51.
  2. Driver, K. (2002). Managing vulvar vestibulitis. The Nurse Practitioner, 27(7), 24-35. Metts, J. (1999). Vulvodynia and vulvar vestibulitis: Challenges in diagnosis and management. Available from American Family Physician (March 15, 1999) // Accessed 10 June 2004.
  3. Friedrich, EG. (1987). Vulvar vestibulitis syndrome. J Reprod Med, 32(110), 110-4.
  4. Gardella, C. (2006). Vulvar vestibilitis syndrome. Curr Infec Dis Rep, 8(6), 473-480.
  5. Heim, L.J. (2001). Evaluation and differential diagnosis of dyspareunia. Am Fam Physician, 63(8), 1535-1544.



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