CO2 Laser vs Lidocaine for Vestibulodynia in Premenopausal Women

Inclusion Criteria: * Age 18 years to 40 years * Hormonal contraceptive therapy for at least one year consecutive duration * Vestibulodynia diagnosis meeting the following criteria: * Localized vulvar pain to vaginal vestibule * At least 3 months duration * Without clear identifiable cause Exclusion Criteria: * Suspected primary cause to vestibular pain that warrants directed treatment * History of chronic infection or autoimmune disease * Prior pelvic surgery including mesh placement for incontinence or prolapse, vestibulectomy, vulvectomy, or labiaplasty * Active vulvar or vaginal infection * Allergy or contraindication to topical lidocaine treatment * Prior diagnosis or treatment of vulvar intraepithelial neoplasia or vulvar malignancy