A.The vestibulitis is a condition where the woman may notice painful sexual intercourse or other vaginal pain, burning, and itching. It can have a lot of different causes, including an infection. Sometimes this infection is difficult to diagnose, and on an occasion doctors treat empirically (i.e., making a guess as to the treatment instead of knowing exactly what the infection is). Sometimes these treatments are related to yeast or other common infections of the vagina. Unfortunately, while many women respond, a large number of women do not get better. This implies that there may be many causes of the condition. This certainly adds to the patient frustration.

One interesting approach is a biofeedback method that involves re-training the muscles around the vagina. Information about this procedure is available at www.vulvodynia.com. I recommend this site with some hesitancy, as it appears to be a particular doctor's own Web site and as such is a bit proprietary. On the other hand, he provides research articles to support the approach, and you might be able to discuss this with your physician.

A. Vaginal dryness during intercourse is common. The cells lining it can produce only so much lubrication before drying ensues. If deficient in Estrogen, then its hormone plays an important role (as occurs with menopause). The vaginal cells often atrophy and are unable to produce as much lubricant, making vaginal dryness common. If you are at menopausal age or have its symptoms (hot flashes, irregular periods, and mood swings), you should get a hormone blood test. If you are in menopause, treatment with estrogen replacement is often effective for vaginal dryness. You may use KY jelly.