There are no cultures, x-rays, or diagnostic tests that can make the diagnosis of vestibulodynia (VVS). A vulvar specialist will examine the patient and test for many other skin conditions, infections and nerve problems. The diagnosis of vestibulodynia (VVS)is made only after all the other possible causes for the patient's symptoms are excluded. This is why making the diagnosis of vestibulodynia (VVS) often takes time. The vulva and vagina of a patient with vestibulodynia (VVS) may look normal or there may be distinct tenderness and at times redness on the vestibule (the opening of the vagina in the area of the hymen). Your doctor will do a "Q-tip test" as well as cultures and possibly biopsies to localize your condition and rule out other causes.