Our Mission and Values

Our mission is to lessen patients’ suffering through improved medical education about vulvovaginal disorders.

Our vision is to reach the day when those with vulvovaginal complaints can approach the medical community with confidence that their needs will be met.

For too long, the topic of vulvovaginal health has been kept “under wraps.” Medical education programs do not prioritize the subject. Clinicians feel ill prepared to cope with unfamiliar conditions. Women hesitate to ask for help, worried that their concerns will be swept aside. Insurance companies reimburse for what to them is merely “vaginitis.” The solution lies with education.

This learning program, informed by years of clinical practice and the best available medical evidence, provides clinicians with practical guidance and systematic methods for the diagnosis and treatment of vulvovaginal disorders.

The program is broad and deep, sensitive to the emotional and physical impacts associated with vulvovaginal disorders.

Authors of

Vulvovaginal Disorders

A Pathway to Diagnosis and Treatment


Elizabeth Gunther Stewart, M.D., FACOG

Dr. Stewart is co-founder and Director Emerita of the Vulvovaginal Service at Harvard Vanguard Medical Associates/Atrius Health in Boston. She is also Assistant Professor of Obstetrics and Gynecology at Harvard Medical School and a member of the Beth Israel Deaconess Medical Center staff. She is a Fellow of the International Society for the Study of Vulvovaginal Disease (ISSVD) and of the American College of Obstetricians and Gynecologists. She is on the Board of Directors for the National Vulvodynia Association.

Dr. Stewart graduated from the George Washington University School of Medicine in 1981 and completed a residency in Obstetrics and Gynecology at Beth Israel Deaconess Medical Center in 1985.

She is the author of The V Book, A Doctor’s Guide to Complete Vulvovaginal Health, and was the co-investigator in the National Institutes of Health-funded first epidemiological study of vulvovaginal pain.


Ione Bissonnette, CNM, MSN

Ione met Dr. Elizabeth G. Stewart and Diana Parks-Forbes, NP, while practicing as a full-scope nurse-midwife at Harvard Vanguard Medical Associates/Atrius Health and Brigham and Women’s Hospital in 1995. Impressed by their ability to diagnose and treat women with vulvovaginal complaints, she became an apprentice to Dr. Stewart over the course of a year and then, in 2003, attended the ISSVD  postgraduate course in Salvador, Brazil. While continuing her midwifery practice, she joined the Vulvovaginal Service at Harvard Vanguard in 2004, and in 2005 became the first Advanced Practice Clinician Fellow of the ISSVD. She is also a member of the National Vulvodynia Association and the American College of Nurse Midwives.

Ione graduated from Columbia University in 1975 with a BS in Nursing and received a master’s degree in Midwifery from the University of Pennsylvania in 1987.

She has lectured on vulvovaginal disorders in various settings, and she and Dr. Stewart initiated teaching sessions at Beth Israel Deaconess Medical Center’s Ob Gyn Residency Program (affiliated with Harvard Medical School) to help integrate this website into the knowledge base of residents and medical students. She is a member of the Core Outcomes for Research in Lichen Sclerosus (CORALS) Delphi consensus study steering group.


Lynette J Margesson M.D., FRCPC, DAAD

Dr. Margesson is Adjunct Assistant Professor of OBGYN and Dermatology at Geisel School of Medicine at Dartmouth College, Hanover, NH. She has held a monthly vulvar clinic at the Dartmouth Hitchcock Medical Center in the Department of OBGYN with Dr. Debra Birenbaum for over 20 years. She was also a specialty consultant at Harvard Vanguard Medical Associates/Atrius Health starting in 1998. She lectures on vulvar disease nationally and internationally and is an active Fellow in the ISSVD. She is the author of two textbooks on vulvar disease and has been a contributor to several others.

She received her medical degree from University of Western Ontario in 1970 and finished her Fellowship in Dermatology in 1975 in Toronto. She was on the teaching staff at Queens University from 1976 until 1997 where she started the first combined vulvar teaching clinic in Canada with the Department of Obstetrics and Gynecology. She moved to New Hampshire in 1997 and was in private practice there in dermatology and vulvovaginal diseases for 20 years. She is committed to promoting vulvar education and awareness of vulvar conditions. Most of the material in the Color Atlas of Vulvar Conditions in this website originated from her book Genital Skin Disorders and subsequent work.


Diana Parks Forbes, NP

Diana Parks Forbes, NP, was the co-founder of the Vulvovaginal Service at Harvard Vanguard Medical Associates/Atrius Health in 1992 and has been helping women with vulvovaginal disease for over 40 years.

She obtained a BSN at Northern Illinois University in 1970 and became a certified nurse practitioner in adult care at Brigham and Women’s Hospital in 1976. She obtained an MSN from Boston University in 1977 and became certified in Women’s Health in 1981.

In the Harvard Vanguard practice, she developed expertise in human sexuality and vulvar disease in children. She has lectured on both those subjects, as well as other topics in vulvovaginal diagnosis and treatment. She now lives in Western Massachusetts and works in a private gynecology practice.

Guest Editors

Our guest editors, Board certified in their fields, have a deep interest in helping women with vulvovaginal problems. All have initiated or work in vulvovaginal specialty practices and have a keen interest in promoting professional education on this topic. This has been their motivation for volunteering to update sections of this website.

  • Deborah Bartholomew, M.D. Professor of OBGYN at The Ohio State University, Wexler Medical Center, Board Certified in OBGYN and Anatomic Pathology. Columbus, Ohio, USA.
  • Amy Boardman, M.D. Associate Professor and Residency Program Director of the OBGYN Department at Atrium Health, affiliated with Wake-Forest School of Medicine, Charlotte, North Carolina, USA.
  • Elizabeth Buechler, M.D., FACOG. Former Chief of OBGYN at Harvard Vanguard Medical Associates/Atrius Health in Boston, now working with Volunteers in Medicine and residents at University of Nevada, Las Vegas, Nevada, USA.
  • Carla Carpenter, O.D., FACOG. OBGYN at West Suburban Women’s Health in Willowbrook, Illinois, USA.
  • Carol Cohen, MSN, RN, WHNP-BC. Department of Gynecology, Boston Children’s Hospital, Boston, Massachusetts, USA.
  • Beth Goldbaum, M.D., OBGYN and Director, Vulvovaginal Service, Harvard Vanguard Medical Associates, Atrius Health. Burlington, Massachusetts, USA.
  • Dee Hartman, PT, DPT. Pelvic floor physical therapist, co-author of The Pleasure Prescription and founder of Vulva Love: Sex Ed for Vibrant Sexuality and Empowered Pleasure. Chicago, Illinois, USA.
  • Cheryl Kinney, M.D. OBGYN at Center for Female Health and Hormone Disorders, NAMS certified Menopause Practitioner. Dallas, Texas, USA.
  • Deborah Lipkin, MSN, RN, FNP. Family Nurse Practitioner at Student Health Services, Boston University, Boston, Massachusetts, USA.
  • Sara McKinney, M.D. OBGYN and Director of Vulvovaginal Service, Beth Israel Hospital, Boston, Massachusetts, USA.
  • Claudia Kraus Piper, MSW, Psychotherapist and Sex Therapist, University of Michigan and private practice. Ann Arbor, Michigan, USA.
  • Cynthia Rasmussen, M.D. OBGYN, former Director Vulvovaginal Service, Harvard Vanguard Medical Associates/Atrius Health, Burlington, Massachusetts, USA.
  • Cara Berg Raunick, RN, DNP. Nurse Practitioner. Director of Clinical Quality and Advancement at Health Care Education & Training, Indianapolis, Indiana, USA.
  • Marcie Richardson, M.D. OBGYN, NAMS certified Menopause Clinician, and Director of Menopause Consultation Service at Harvard Vanguard Medical Associates/Atrius Health and Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
  • Leslie Sadownik, M.Ed., M.D. Associate Professor of OBGYN and Associate in Department of Dermatology, Director Emerita of Centre for Vulvar Health at University of British Columbia, Vancouver, British Columbia, Canada.
  • Amanda Selk, M.D., M.Sc. OBGYN and Coordinator of Vulvar Gynecology-Dermatology Clinic, and Fellowship Director for Vulvovaginal Conditions Fellowship at University of Toronto. President of the North American Chapter of the International Society for the Study of Vulvovaginal Disease (ISSVD) and the Society of Canadian Colposcopists. Toronto, Ontario, Canada.
  • Amy Stenson, M.D. M.P.H. Associate Professor of OBGYN School of Medicine at Oregon Health and Science University, Portland, Oregon, USA.
  • Kristen Stewart, M.D. Dermatologist at Total Dermatology Care Center in Jacksonville, Florida, USA.
  • Kelly Tyler, M.D. Board certified in both Dermatology and OBGYN. Associate Professor of Dermatology at The Ohio State University, Wexler Medical Center. Columbus, Ohio, USA.


All four of the original authors, in the course of practicing Ob Gyn or Dermatology, saw patients with problems we could not solve, pain, dyspareunia, or intractable itching we could not fix, and other conditions that went beyond STIs and the trio traditionally taught: bacterial vaginosis, yeast infection, trichomoniasis. Without much evidence in the literature, we learned what we could, apprenticing with those who knew more than we did, each becoming committed to not giving up on the women who had shuttled from clinician to clinician trying to find answers and relief.

We gained some valuable experience and successes in helping women, who told us, “You didn’t just help me, you saved my life!” We became determined to share what we had learned, to fill in the blanks for practitioners in the insufficient vulvovaginal medical educational system.

We conceived the idea of a diagnostic algorithm which would specify the steps we took in clinical practice. That algorithm expanded, over the years, into this website. Early funding for website came from Harvard Vanguard Medical Associates, the Board of Atrius Health Foundation, and from the generous donations of patients and their families. Subsequent support has come from our fiscal sponsor Our Bodies Ourselves and The Vagina Collective.

Gender & Sexual Identity

We honor the changing perceptions of gender and sexual orientation, whether cisgender or LGBTQIA2S+. In this website, which is based on an understanding of basic vulvovaginal health, we use the terms woman, women or patients as they have been used in studies or in practice. We encourage the reader to consider the specific counseling and treatment needs of transgender and gender diverse individuals.

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