Infectious conditions, such as recurrent or complicated yeast, trichomonas, and herpes. These conditions are diagnosed by microscopically examining and culturing vaginal discharge. Treatments can include long-term antifungal use, both topical and/or medications, and antivirals and antibiotics.
Inflammatory skin disorders such as atrophic vulvovaginitis, allergic vulvovaginitis, lichens simplex chronicus, lichens sclerosis, lichen planus and desquamative vaginitis. These disorders are diagnosed by distinctive characteristics of the skin and the vaginal tissues, or by biopsy. Treatments can include topical steroids or topical immune modulators, antihistamines, topical numbing preparations and topical estrogens; often a combination of these therapies are used.
Neurological disorders such as pudendal nerve entrapment or injury from childbirth or trauma, including sports injury, referred pain from ruptured disc, herpes neuralgia, pelvic floor dysfunction, or neurologic diseases such as multiple sclerosis. Treatment for these aspects encompasses treating the underlying condition.
Neoplastic (cancerous or precancerous) disorders such as squamous cell carcinoma and vulvar intraepithelial neoplasia (VIN). These conditions are diagnosed by biopsy and have a range of treatment depending on the severity of the lesions. Mild lesions may be treated with topical immune response modifiers; others may need to be excised or removed surgically.
Vulvodynia or vulvovestibulitis syndrome, vestibulodynia, vulvar dysesthesia, clitorodynia, and vaginismus. These conditions are diagnosed by excluding all other causes of the vulvovaginal pain and are based on symptoms. In the case of vestibulodynia, which is the most common vulvar pain condition, the presence of symptoms known as Fredrich criteria confirm the diagnosis.