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Vulvar vestibulitis syndrome is believed to be the most common form of painful intercourse in premenopausal women, affecting an estimated 12% in the general population. Women with vulvar vestibulitis typically experience a severe sharp, burning pain localized at the entrance of the vagina (i.e., the vulvar vestibule). This pain occurs upon contact, through both sexual and nonsexual stimulation. Approximately half of the women with vulvar vestibulitis syndrome have “primary” vestibulitis, that is, they have experienced the pain from their first intercourse attempt, whereas the other half of the sufferers develop the pain after a period of pain-free intercourse, termed “secondary” vestibulitis. Characteristics of the Vulvar Vestibule in Affected and Non-affected Women To answer the question of what causes vulvar vestibulitis, it is necessary to start with where the vulvar vestibule is located and its normal tissue characteristics. The vulvar vestibule is a part of the external genitalia (i.e., the vulva). It extends from the inner aspects of the labia minora to the hymen, is bordered anteriorly by the clitoral frenulum and posteriorly by the fourchette, and includes the vaginal and urethral openings. The vestibule is innervated by the pudendal nerve and contains free nerve endings, the majority of which are believed to be C-fibers, otherwise known as pain fibers. Although the vulvar vestibule is composed of visceral tissue, it has a nonvisceral innervation. Therefore, sensations of touch, temperature, and pain are similar to those evoked in the skin. The suffix “-itis” refers to conditions of inflammatory origin and, in the case of vulvar vestibulitis, implies that the pain is due to an inflammation of vestibular tissue. However, studies examining indices of inflammation in this tissue suggest that inflammatory infiltrates are common in the vestibule, and thus, not necessarily related to the pain. Other controlled investigations of vestibular tissue suggest that altered pain processing plays a role in the development and/or maintenance of vulvar vestibulitis. Evidence for this includes the following: a heightened innervation of intraepithelial nerve fibers, an increase in blood flow and erythema, nociceptor sensitization, the presence of calcitonin gene-related peptide (i.e., a peptide that exists in pain nerves), and lower pain thresholds. These tissue properties would lead to an increase in sensation in response to vestibular pressure, consistent with the clinical picture of provoked pain in women with vestibulitis. Taking a cotton-swab, for example, and touching different areas of the vestibule in a non-affected woman is perceivable but not painful, but this same stimulation in the vestibule of a vestibulitis sufferer is perceived as excruciatingly painful.
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About The Author David Crawford is the CEO and owner of a Penis Enlargement Pills company known as Male Enhancement Group which is dedicated to researching and comparing male enhancement products in order to determine which male enhancement product is safer and more effective than other products on the market. Copyright 2010 David Crawford of Penis Enlargement Reviews This article may be freely distributed if this resource box stays attached.
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