In general, the shorter the duration of the syndrome, the better the outcome. The patient needs to develop positive coping mechanisms to control the pain such as exercise, distraction techniques, and active participation in managing the pain. Dyspareunia at the entrance to the vagina is the essential characteristic of this condition. Sometimes it occurs secondary to dermatological conditions such as lichen sclerosus or desquamative vaginitis. Frequently, the initiating factor in VVS appears to be a history of serial antibiotic use for urinary tract infections, acne, sinus infections, or vaginitis, or the use of highly progestational agents such as certain birth control medications.
Symptoms always intensify from the use of pantyliners or menstrual pads.
Topical estrogen such as Estrace cream should be applied to gland openings to relieve symptoms of burning and reduce inflammation. The use of topical and intravaginal steroids also may be beneficial. Some of the commonly used treatments for VVS do not appear to have a high success rate. One of the popular alternative methods, the low-oxalate diet plus calcium citrate, does not work for most VVS patients. Likewise, oral corticosteroids are ineffective.