The V Book came out in July 2002 and has now gone into its third printing. It is available in the United Kingdom and has just come out in Chinese.

Since the V Book went to press, new developments have occurred. Clinicians have long suspected that vulvar vestibulitis or vestibulodynia, the leading cause of painful intercourse in women under the age of 50, is caused by repeated yeast infections in some women. A Swedish study now provides the first step in proving that this might be true for a subset of women with vestibulitis. In sexually active adolescents, who underwent genital examination, yeast cultures were positive 42%. Frequent oral-genital sex was associated with the growth of yeast, and pain at first intercourse was associated with the growth of yeast and recurrent yeast infections. The study also showed a trend towards a relation between positive yeast cultures and frequent consumption of sweets. (Rylander E, Berglund A-L, Krassny, C, Petrini B. Vulvovaginal candida in a young sexually active population: prevalence and association with oro-genital sex and frequent pain at intercourse. Sex Transm Infect 2004; 80:54-57)

These researchers think that chronic yeast may be an initiating factor for vestibulitis. They are suggesting that recurrent yeast in combination with the oral contraceptive pill might strain the sensitive tissue of the vulvar vestibule. (Read the V Book if you don’t know about this part of the vulva!) We know, from another recent study since the V Book was written, that regular intercourse and/or the use of the Pill before 16 years of age and for more than 2 years was significantly associated with pain at intercourse. The progesterone in the pill slightly thins the vagina and decreases the number of the good bacteria that live there, lactobacilli. In the long run, this situation may affect the superficial nerve endings in the vestibule causing them to overreact and cause the pain with intercourse.

Previous News:
Use of Tricyclic Antidepressants for Chronic Vulvar Pain
Inaccurate Self-Diagnosis of Yeast Infections