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Yeast infections Many etiological theories exist regarding what initiates the increase in sensitivity of the vulvar vestibule in sufferers. One of the most consistently reported findings associated with the onset of vulvar vestibulitis is a history of repeated yeast infections. However, it is not clear whether the culprit is the yeast itself or treatments undertaken which can sensitize the vestibular tissue or an underlying sensitivity already present in the tissue. Many women, like Sandra, when they feel the irritation during intercourse do not go to the doctor’s office to have a culture taken before they treat what they think is a yeast infection with over-the-counter remedies from the local drugstore. At the same time, some gynecologists may not perform the culture themselves, and on the basis of symptomatic description alone, suggest to the woman that she has a yeast infection. It is vital that both the woman and her health care professional ensure that treatment is not being undertaken without reason, as this can aggravate the problem. Hormonal factors Hormonal factors have also been found to be associated with vestibulitis in controlled studies. Bazin and Bouchard found that women who used oral contraceptives had an increased risk of developing vestibulitis later in life, with those starting before the age of 16 being especially at risk. Early menarche (i.e., before the age of 11) and painful menstruation were also associated with an increased risk of vestibulitis. These findings suggest that hormonal factors may play a role in the increase in sensitivity of the vulvar vestibule, but the question of how hormones are involved remains to be elucidated. Genetic factors In one controlled study, Jeremias found that affected women have a high incidence of a genetic allele that is involved in the regulation of inflammation and is associated with chronic inflammatory conditions (e.g., ulcerative colitis, inflammatory bowel disease). It is possible that women with this allele are genetically susceptible to the development of vestibulitis, but may only develop it after some injury to the vulvar vestibule, whether through repeated infections, local treatments, hormonal factors, early age at first intercourse, early age at first tampon use, and/or difficulty with or pain during first tampon use. Although these findings need to be replicated, they lead to several possible explanations for the development of vulvar vestibulitis. For example, women with this particular gene profile may have an abnormality in the regulation of inflammation, which has recently been shown in vestibulitis sufferers. This would allow vulvar vestibulitis to be one of many expressions of this gene; others would include colitis and inflammatory bowel disease. In addition, it would imply that women with vulvar vestibulitis might have associated pain problems and/or sensory abnormalities. Although just beginning to be examined, controlled studies support this implication. Women with vulvar vestibulitis have a higher sensitivity to vestibular touch, a higher sensitivity to nonvestibular touch, painful pressure, and heat pain, in addition to more somatic pain-related complaints when compared with non-affected women. Other factors Many other physically based etiological theories of vulvar vestibulitis exist; however, they are based on uncontrolled studies and should be interpreted with caution. These include human papillomavirus infection, faulty immune system functioning/allergies, urethral conditions (e.g., interstitial cystitis), vaginismus, sexual abuse, and psychological factors (e.g., somatization disorder). It is important to note that controlled studies of sexual abuse show no difference between affected and non-affected women, although a history of depression and physical abuse has been linked to vulvar vestibulitis. Furthermore, an increase in pelvic floor muscle tension has also been associated with vulvar vestibulitis. Although the tensing of pelvic floor musculature may represent a protective reaction against, or a conditioned response to vulvar pain, this increase in tension is likely to only exacerbate the pain.
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About The Author David Crawford is the CEO and owner of a Natural Penis Enlargement 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 Products This article may be freely distributed if this resource box stays attached.
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