The cause of vulvar vestibulitis is not known. Early studies implicated the human papilloma virus as a cause, but this is no longer considered to be associated with vulvar vestibulitis. There appears to be a small subset of women who have chronic yeast infection as a cause of their vestibulitis, and long term yeast suppression has met with promising results in these women. Because the vestibule and a portion of the bladder are the only two tissues in the body derived from the same embryologic tissue, investigators have begun to look for an irritant which might affect both of these structures. To date, no causative agent has been proven.
Some patients relate the onset of their pain to a gynecological or obstetric event.
Where chronic yeast infection can be identified, suppression of yeast growth can be gratifying. Other topical therapies such as steroids and antibiotics have not met with success. The greatest success in treating vulvar pain conditions comes from using a group of medications called antidepressants. This in turn can prevent these specific nerves from transmitting the message to the brain where it is processed and pain is perceived. Another group of drugs, anticonvulsants, are used as treatment for other chronic pain conditions and may be used for vulvar pain.