The Vulvar Vestibule, a Small Tissue with a Central Position: Anatomy, Embryology, Pain Mechanisms, and Hormonal Associations

AbstractThe vulvar vestibule is the tissue located between the vagina and the vulva, comprising the vaginal introitus. It is mainly considered in the context of localized provoked vestibulodynia, a pain condition causing dyspareunia in 8 –16% of women.Purpose of ReviewTo describe the vulvar vestibule ’s unique properties, which may have a role in the development of vestibular tenderness and dyspareunia.Recent FindingsThe vestibule displays different neural features when compared with neighboring organs. It is an immunologically diverse tissue that exhibits highly localized and tissue-specific pro-inflammatory responses. Systemic, as well as local hormonal-associated processes regarding estrogen, androgens, and usage of hormonal contraception apear to influence the pain threshold in the vestibule.SummaryThe vestibule, emerging from the embryonic endoderm, exhibits unique features regarding innervation, inflammation, and hormonal stimuli. A better understanding of these mechanisms is required in order to advance our understanding of introital dyspareunia.
Source: Current Sexual Health Reports - Category: Sexual Medicine Source Type: research