Do you also have pain in the area around the vagina? Let's talk about this (Vestibulodynia)!

Do you sometimes feel pain or burning at the entrance to your vagina? This pain can occur during sex or even just when you are still. This is a problem that is often not talked about among women, but it affects many people. So today we will talk about this in a little more detail .

What is this (Vestibulodynia)? Let's understand it simply?

Simply put, vestibulodynia is pain that occurs in the area around the entrance to your vagina, called the vestibule . This pain can sometimes also occur in other parts of the external genital area around the vagina, called the vulva . It is a very bothersome, long-lasting pain. Sometimes no clear cause can be found. Your doctor may also call this condition vulvar vestibulitis syndrome , or (VVS) for short.

Now you may be wondering what the vulva is. It is the externally visible part of a woman's reproductive system. To be precise, it protects your internal reproductive organs, such as your vagina, uterus, and ovaries. It also protects your urethra , the tube through which urine exits.

The vulva is an area that is very important for your sexual response and orgasm. It has these parts:

• Clitoris
• Inner lips (labia minora)
• Outer lips (labia majora)
• The entrance to the vagina (vestibule)

What is the difference between (Vulvodynia) and (Vestibulodynia)?

These two names can be a bit confusing, but let's keep it simple. Vestibulodynia is a type of condition that falls under the larger category of Vulvodynia . Both conditions involve pain in the vulva area for no apparent reason.

There are two main types of vulvodynia :

1. Generalized vulvodynia: This is when there is persistent pain in several areas of the vulva , not just one.

2. Localized vulvodynia: In this, the pain is only in one specific area of ​​the vulva . For example, pain at the entrance to the vagina (called vestibulodynia ) or pain in the clitoris (clitorodynia) . Of these, vestibulodynia, which is caused by some pressure or pressure, is the most common type of localized vulvodynia . We call it provoked vestibulodynia .

What is Provoked Vestibulodynia?

As the name suggests, provoked vestibulodynia is pain that occurs when there is pressure or pressure on your vestibule. This pressure is what "provokes" this chronic pain, which can last for more than three months. This pressure can be caused by things like:

• A pelvic exam performed by a doctor.
• When you sit in one place for a long time.
• During sex.
• When wearing tight clothes (e.g. tight pants).
• When something is inserted into the vagina, whether it's a finger, penis, tampon, or sex toy .

Imagine, Nimali is someone who sits in the office for hours on end every day. For a few days, she started feeling a slight burning sensation in her vagina. Although she didn't care at first, the pain increased after having sex. She was so scared that she couldn't tell anyone about it. You may have had a similar experience.

What are the types of Provoked Vestibulodynia?

There are two main types of this too:

1. Primary (congenital) provoked vestibulodynia: This is when the pain occurs when you try to insert something into your vagina for the first time in your life (e.g., when having sex for the first time, when trying to insert a tampon). This is a congenital condition, meaning it can be present from birth.

2. Secondary (acquired) provoked vestibulodynia: In this, the pain occurs days, months, or even years after you were previously able to insert something into your vagina without any pain. This is a condition that develops over time.

How common is vestibulodynia?

In fact, it's estimated that about one in four women will experience some form of vulvodynia , which is pain in the vulva that has no apparent cause. Most of the time, this pain is triggered by external pressure or touch (called " provoked ").

But the actual number of cases may be higher. Some people are embarrassed to talk to their doctors about this problem. Others think that this is something that cannot be cured and must be lived with for the rest of their lives. But that is not the case, there is a treatment for this!

What are the causes of vestibulodynia?

Experts still don't know exactly what causes this. But there are some theories. One is that some people may have more pudendal nerves in the vulva . These pudendal nerves are what send sensations like pain and pleasure to your nervous system.

Some people have a condition called neuroproliferation (also called neuroproliferative vestibulodynia ). This means that their pudendal nerves become very sensitive. They may feel extreme pain ( hyperalgesia ) even to the slightest touch ( allodynia ). This neuroproliferation can be something that is present at birth or can develop later due to damage or irritation to the nerves.

Who is at higher risk of developing vestibulodynia?

Although this condition can occur in anyone, it is most common in sexually active white and Asian women between the ages of 20 and 40. It can also occur more frequently in women who have gone through menopause and have conditions such as vaginal dryness and vaginal atrophy .

You are more likely to develop this condition if you have any of the following:

• Allergic reactions or sensitivities to certain scented soaps, detergents, pantyliners, etc.
• Chronic yeast infections .
• Conditions like fibromyalgia .
• Genetic predisposition to chronic pain, inflammation, or infection.
• (Interstitial cystitis) (painful bladder).
• Joint pain or musculoskeletal pain .
• Mood disorders such as depression or bipolar disorder .
• Pelvic floor dysfunction , weakness or muscle spasms.
• Trauma caused by sexual abuse (rape) or complications during childbirth.

What are the symptoms of Vestibulodynia?

Vestibulodynia is a type of nerve-related pain (neuropathic pain) . This pain lasts for at least three months. The pain may be constant or may come and go (which is called intermittent ).

The main symptoms of vestibulodynia are:

• Burning, stabbing, or knife-like pain in the vestibular area.
• Pain when inserting something into the vagina, sitting, or engaging in physical activity such as running, cycling, or horseback riding.
• Painful sexual intercourse (dyspareunia) .
• Painful urination (dysuria) .
• Sensitivity, dryness, redness, and sore-like appearance of the vestibule area.

What other conditions can occur with Vestibulodynia?

Some people may have both of these conditions along with Vestibulodynia :

• Clitorodynia: This is also a type of localized vulvodynia . It is characterized by severe pain in the clitoris .
• (Vaginismus): This is when your vaginal muscles tighten and contract without you even realizing it whenever you try to insert something into your vagina.

How is Vestibulodynia diagnosed?

There is no specific diagnostic test to diagnose this. Your doctor will listen carefully to your symptoms. During a pelvic exam , your doctor will take a cotton swab and gently apply pressure to different areas of your vulva , asking you how painful it is.

You can also run one or more of these tests to see if there are any other problems, or to make sure there aren't any:

• Blood tests.
• Urinalysis or urine culture tests - These are done to check for urinary tract infections (UTIs) , cystitis , yeast infections , and sexually transmitted diseases and infections (STDs and STIs) .
• Pap smear and, if necessary , colposcopy - these are done to check for abnormal cells in the cervix (cervical dysplasia) or cervical cancer .
• Skin biopsy - to check for skin diseases.

What kind of doctors treat vestibulodynia?

Even though this condition affects your genitals, it doesn't necessarily have to be a gynecological problem. You will need to see a variety of specialists for treatment. These include:

• Obstetrician/gynecologist (`Ob/Gyn`).
• Dermatologist.
• Neurologist.
• Pain management specialist.
• Pelvic floor physical therapist.
• Psychologist, sex therapist or couples therapist.
• A specialist in the urinary system and female reproductive system (`Urologist` or `urogynecologist`).

How do doctors treat vestibulodynia?

Treatment for vestibulodynia is primarily aimed at reducing pain and controlling symptoms .

These are non-medicinal treatments:

• Types of pain-relieving and numbing creams (`Anesthetic (numbing) skin creams`).
• Cognitive behavioral therapy (CBT) , couples therapy, or sex therapy.
• Lifestyle changes - for example, wearing loose clothing and cotton underwear, and not using scented products.
• Pelvic floor physiotherapy - for example, Kegel exercises (pelvic floor exercises) and biofeedback techniques.
• Using vaginal lubricants and vaginal dilators.

Medicinal treatments are:

• Antidepressants .
• Medicines for epilepsy and nerve pain - e.g. gabapentin .
• Botulinum toxin injections (Botox®) .
• Topical corticosteroid creams or steroid injections.
• External hormone creams (hormone therapy) .
• Nerve blocks .
• Pain relievers.

Can Vestibulodynia be cured with surgery?

Some people with provoked vestibulodynia who do not respond to other treatments may benefit from surgery to remove sensitive skin and tissue. This surgery is called a vestibulectomy . This often provides permanent relief of symptoms.

Can Vestibulodynia be prevented?

By following these steps to care for your vulva , you can prevent and reduce vulvar pain:

• Avoid using scented products (e.g., feminine deodorant spray, talcum powder, scented panty liners) on your genital area.
• Do not use intravaginal contraceptives (e.g. diaphragms, cervical caps). Also, do not use spermicides and contraceptive foams, as they can cause irritation.
• After urinating, instead of using toilet paper, wash the genital area with water from a squeeze bottle or a bidet.
• Use unbleached toilet paper and unscented sanitary products (tampons, pads).
• Sit on a doughnut-shaped pillow to reduce pressure on your vulva .
• Soak in a hot tub to reduce pain.
• Wash your genital area with water only (no soap). Do not use bubble bath, bath salts, or bath oils.
• Wear cotton underwear, loose pants or shorts. Avoid wearing pantyhose, tights or tight leggings.

What are the possible complications of vestibulodynia?

Chronic pain caused by vestibulodynia can be very uncomfortable and even life-threatening. It can affect exercise and even sitting for long periods of time.

Vestibulodynia can also cause sexual dysfunction . This can affect your ability to enjoy sex, and it can also negatively affect your relationships and self-esteem. You and your partner may benefit from talking to a therapist, such as a couples therapist or sex therapist.

What is the outlook for someone with vestibulodynia?

Vestibulodynia often gets better over time (called remission ). Unfortunately, this vulva pain can come back (called relapse ). Therefore, it is important to follow your doctor's instructions to prevent and reduce vulva pain.

When should I see a doctor?

If you experience any of these symptoms, you should definitely see a doctor:

• Abnormal vaginal discharge with a bad odor.
• Itching in the genital area.
• Painful intercourse.
• Painful urination.
• Symptoms of a yeast infection , urinary tract infection (UTI) , or other infection.

What questions should I ask my doctor?

It's a good idea to ask your doctor questions like these:

• Why did I develop this (Vestibulodynia) ?
• What type of Vestibulodynia do I have?
• What treatment options do I have?
• Should I consider medication or surgery?
• Should I be aware of symptoms of complications?

Can vestibulodynia be caused by sexually transmitted diseases (STDs)?

No. There is no known link between vestibulodynia and sexually transmitted diseases (STDs) . However, some STDs, such as chlamydia and gonorrhea, can cause similar symptoms, such as pain and inflammation. Therefore, it is important to see a doctor to determine the exact cause of these symptoms and get appropriate treatment.

Vulvar pain caused by vestibulodynia is a real thing. Don't be shy about talking to your doctor about painful insertion or persistent pain in your vulva . You may have vestibulodynia , a type of vulvodynia that causes chronic pain in your vestibule. Vestibular pain often comes on suddenly and for no apparent reason. Medications and non-drug treatments can help.

The most important things to remember (Take-Home Message)

Okay, so I hope what we've talked about has helped you remember some of the most important things. Vestibulodynia is not something to be ashamed of.

• You are not alone: ​​You are not the only one with this problem. Many women suffer from this condition.
• A cause can be found: Although the cause of all pain cannot be found immediately, a cause can often be found by talking to a doctor and doing tests.
• There are treatments: This is not an incurable disease. There are various treatments available to reduce pain and make life easier.
• Don't be shy: Never be shy about talking about your health or asking for help. A doctor is someone who is there to help you.

Therefore, if you have any of these symptoms, please see a doctor for advice. Your comfort and happiness in life are very important to you.

` Vestibulodynia, Vulvodynia, Vaginal Pain, Sexual Pain, Vulva, Women's Health, Provoked Vestibulodynia