The International Society for the Study of Vulvovaginal Disease (ISSVD) revised the terminology and classificationof vulvodynia based on experience with previous systems.


Vulvodynia is defined as:

(1) vulvar discomfort including a burning pain

(2) exclusion of a specific pathologic cause (idiopathic or primary)


Vestibulodynia replaced the term vestibulitis in idiopathic cases since inflammation had not be demonstrated as being involved. (The term vestibulitis would be appropriate in the setting of infection, autoimmune disease or other condition with inflammation.)


Parameters for classifying a patient:

(1) distribution

(2) trigger



(1) localized: vestibulodynia, clitorodynia, hemivulvodynia

(2) generalized


In theory involvement might be localized to 2 areas (referred to as multifocal in the implementation).



(1) provoked: secondary to an inciting cause (intercourse, tampon insertion, finger pressure, cotton swab, clothing pressure, etc).

(2) unprovoked

(3) mixed with symptoms both provoked and unprovoked


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