Vulvar Vestibulitis Syndrome (VVS) is a heterogeneous, multisystemic, and multi-factorial disease, and is one of the leading causes of dyspareunia in fertile women. As a multisystemic disease, it involves the mucous structure of the vulvar vestibule and the immune, muscular, vascular, and nervous systems, and involves pain fibers and centers. As a multifactorial disease, it’s etiology is complex and multiple, involving biological, psychosexual, and relational factors. The progression of the disease, and the impact of an often lengthy delay between the onset of symptoms and a correct diagnosis are discussed. Moreover, despite documented improvements from available treatments, VVS becomes a chronic disease, unless diagnosis is early, and an integrated, pathophysiologically-oriented treatment is offered in an experienced center. Health care providers would therefore benefit from approaching the condition within a management framework focused on the woman’s chronic pain, the impact on the couple’s relationship, and any psychological sequelae from the condition.
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