Vulvar vestibulitis syndrome and vaginismus -: A case report

BACKGROUND: Recent reports have argued for a revision of the criteria used for the establishment of a diagnosis of vulvar vestibulitis syndrome (WS). On theoretical grounds it might be hypothesized that women with VVS also suffer from vaginismus. CASE: A young woman presented with a history, symptoms and objective findings typical of vaginismus, yet she suffered from continuous, bunting pain and itching in the vestibule. Earlier in the course of the problem she had received a diagnosis WS. The patient was treated with behavioral therapy developed for vaginismus. Notations made during the course of therapy supported the assumption that the pain and itching were conditioned responses to penetration in the same way that a vaginal muscular reflex is. CONCLUSION: Differential diagnostic difficulties exist in the field of VVS and vaginismus. Psychophysiologic theories are needed as the basis for research to clarify the connections between different diagnostic entities associated with coital burning pain and itching in the vestibule.