Dr. Chang Min-Chieh, director of Chang Min-Chieh Clinic
Modern women often face a wide range of health challenges, particularly in the field of gynecology, where some symptoms persist without clear diagnosis or effective treatment, falling under what is known as “women’s complex disorders.” According to Dr. Chang Min-Chieh, director of Chang Min-Chieh Clinic, these symptoms often involve more than a single bodily system—they are influenced by a combination of physical, neurological, and endocrine factors.
Dr. Chang further explains that among neurological issues, vulvar vestibular neuritis is a frequently overlooked condition. It is an external manifestation of vagus nerve inflammation and is considered a comorbidity of vagal neuropathy. The disease primarily presents as a burning sensation, pain, and tenderness in the vulvar area—particularly aggravated by tight clothing or sexual activity. One notable feature is that while the symptoms are quite apparent, pathological tests often come back negative, leading to misdiagnoses as psychological in origin and missed opportunities for proper treatment.
Upon deeper investigation, the core cause of vulvar vestibular neuritis appears to be dysfunction of the autonomic and sensory nervous systems. The vagus nerve, uniquely functioning as a "bridge nerve" with both somatic and autonomic components, plays a crucial role in this condition.
Dr. Chang notes that the vagus nerve regulates heart rate, digestion, vocalization, and is also closely linked to emotional and stress responses. When vagal regulation is disrupted, it can not only lead to symptoms of autonomic nervous system imbalance but may also trigger hypersensitive neural reactions in the vulvar area, resulting in chronic pain.
For instance, a 60-year-old woman surnamed Lee reported involuntarily urinating as soon as she thought about needing to use the restroom, leaving her reliant on adult diapers throughout the day. She also suffered from acid reflux, bloating, chest tightness, and heart palpitations. After years of fruitless visits to various hospitals and clinics, she was finally diagnosed with vulvar vestibular neuritis. Following treatment, all symptoms were completely resolved.
Another case involved a 56-year-old woman surnamed Tsai who had long been plagued by vulvar pain and itching, burning mouth syndrome, frequent oral ulcers, back pain, neck and shoulder soreness, headaches, insomnia, chest tightness, heart palpitations, acid reflux, bloating, plantar fasciitis, and painful intercourse. Her quality of life had severely declined. After years of seeking help with no clear diagnosis—becoming what many doctors deemed a "difficult case"—Dr. Chang diagnosed her with vulvar vestibular neuritis combined with autonomic nervous system dysfunction. After receiving treatment, nearly all of her symptoms improved significantly, and her satisfaction rating was 10 out of 10.
Dr. Chang emphasizes that when addressing complex female disorders, one must move beyond the traditional organ-based diagnostic approach. Instead, a comprehensive strategy should be adopted—focusing on nervous system regulation, autonomic balance, and overall physical and mental well-being. This includes integrating neural rehabilitation, psychological support, and localized therapies. Only through such a holistic approach can the longstanding health challenges faced by women truly be resolved.
