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Authors: Vanessa Ngan, Staff Writer, 2003; Dr Jasmine Mann, ST5 Dermatology Registrar, University Hospitals of Derby and Burton NHS Foundation Trust; Dr Maulina Sharma, Consultant Dermatologist, University Hospitals of Derby and Burton NHS Foundation Trust; Miss Shuchi Dixit, Consultant Gynaecologist, University Hospitals of Derby and Burton NHS Foundation Trust, United Kingdom. Copy edited by Gus Mitchell. April 2021.
Cyclic vulvovaginitis is a descriptive term referring to recurrent burning and itching of the vulva and/or vagina that recurs at the same phase of the menstrual cycle.
The three major causes of cyclic vulvovaginitis are:
Cyclic vulvovaginitis can affect menstruating women of all ages and races.
The aetiopathogenesis of cyclic vulvovaginitis depends on the specific cause and may include:
Cyclic vulvovaginitis is a clinical diagnosis based on history and examination. The Q-tip test should be performed to check for provoked vulvodynia.
Vaginal swabs and scrapings for smear and culture should be performed during the symptomatic phase and, if negative, again in the asymptomatic phase. If a Candida sp. is cultured, the specific strain and drug sensitivities should be reported.
Cyclic vulvovaginal symptoms can also be due to:
For vulvovaginal candidiasis:
For cytolytic vaginosis:
For autoimmune progesterone dermatitis:
Vulvodynia is best managed by a specialist vulval clinic.
The outcome of cyclic vulvovaginitis depends on the cause. Correct identification and treatment can result in resolution of symptoms but may require long-term intermittent or continuous treatment.
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