The vestibulitis syndrome. Medical and psychosexual assessment of a cohort of patients.

OBJECTIVE

To study medical, psychosexual, personality and relationship parameters and the resulting illness behavior and psychopathology in patients with the vestibulitis syndrome.

STUDY

DESIGN

Following full medical screening, questionnaires were administered that included assessment of vulvar pain, sexual history, personality, depression and illness behavior. The 50 patients who met the diagnostic criteria of vestibulitis syndrome formed the cohort of this study.

RESULTS

Medical and psychological conditions most frequently reported included vulvovaginal candidiasis (96%), premenstrual syndrome (85%), dysmenorrhea (85%), urologic symptoms (67%), depression (60%), change in body image (63%) and suicidal ideation (57%). The mean duration of dyspareunia-associated vulvar pain was 85 months (range, 2-480), with an associated decrease in sexual interest, desire and activity (91%). Although patients satisfied a number of somatization disorder criteria related to age, course of the condition, gastrointestinal symptoms, sexual problems and multiple pain sites, there was insufficient evidence for such a diagnosis. Patients scored high on personality scales, including organization, concern about mistakes and personal standards.

CONCLUSION

Common medical profiles, personality traits and psychosexual problems highlight the parallelism between the vestibulitis syndrome and somatization disorders, but subtle variations allow differentiation on clinical assessment.