Vestibulodynia
Vestibulodynia is a chronic pain disorder that affects a significant number of women. This condition can be incredibly debilitating and can interfere with daily activities, including sexual activity. Despite its prevalence, it is often misdiagnosed or underdiagnosed, leaving many women suffering in silence.
Table of Contents
- What is vestibulodynia?
- Understanding the symptoms of vestibulodynia
- What causes vestibulodynia?
- Diagnosing vestibulodynia
- Treating vestibulodynia: Medical and non-medical options
- Medications for vestibulodynia: Topical and oral
- Physical therapy for vestibulodynia
- Alternative treatments for vestibulodynia
- Coping with vestibulodynia: Emotional support and self-care
What is vestibulodynia?
Vestibulodynia is a chronic pain condition that affects the vulva in women. It’s characterized by sharp, burning, or stinging pain that is triggered by touch or pressure of the the vestibule, which is a small area at the entrance of the vagina.
It’s important to note that vestibulodynia is not a sexually transmitted disease or the result of poor hygiene.
There are various treatment options available, including topical medications, physical therapy, and lifestyle changes that can help manage the symptoms of vestibulodynia and improve your quality of life.
Understanding the symptoms of vestibulodynia
Symtoms of vestibulodynia include vestibular pain at the entrance to the vagina, described as burning, stinging, or raw sensation that is felt in the vulvar area and is typically provoked by touch or pressure. The pain can be so severe that it can make sexual intercourse, tampon use, or even sitting for extended periods of time unbearable.
Vestibulodynia symptoms can vary from person to person and may include
- Pain during intercourse, a burning or stinging sensation in the vulvar area
- Pain during tampon use
- Discomfort during gynecological exams.
These symptoms can be triggered by various activities such as exercise, prolonged sitting, wearing tight clothing, or even just touching the vulvar area.
Vestibulodynia is a chronic pain condition, which means that the symptoms can persist for months or even years. The pain can be debilitating and can have a significant impact on a person’s quality of life, including sexual health and mental well-being.
What causes vestibulodynia?
Vestibulodynia is a condition that causes chronic pain in the vulvar vestibule, which is the area surrounding the entrance to the vagina. Causes may include:
- Neuronal Proliferation: this is due to increased nerve fibers in the vestibular area and this can be lifelong or due to reactions of the body to irritants or allergens.
- Pelvic Floor Hypertonicity: muscle tension or spasms in the pelvic floor muscles. This can be due to a variety of factors, including stress, anxiety, and poor posture. The muscle tension or spasms can put pressure on the nerves in the vulvar vestibule, leading to pain and discomfort.
- Hormonal: The vestibule is rich in receptors for both estrogen and testosterone. Changes in hormones due to menopause, surgery or medications can result in hormonally induced vestibulodynia.
Diagnosing vestibulodynia
Diagnosis is confirmed through a thorough history of your symptoms and medical history and a physical examination. This includes a pelvic exam where a cotton swab is used to apply pressure to different areas around the vulva to determine where the pain is located. Also, digital palpation and using a small vaginal speculum to assess the muscles and tissue so the vagina can be helpful to rule out other conditions.
Treating vestibulodynia: Medical and non-medical options
There are various treatment options available for vestibulodynia, including both medical and non-medical approaches. The first step in treating vestibulodynia is to identify the underlying cause of the condition, as this can help in determining the most effective treatment plan.
Medical treatments for vestibulodynia may include topical medications such as lidocaine or estrogen and testosterone creams, oral medications such as antidepressants, or even nerve blocks or botox to the area. In some cases, surgery may be necessary to remove the affected tissue or nerves.
Non-medical treatments for vestibulodynia can be just as effective and may include physical therapy, pelvic floor muscle relaxation exercises, or the use of vaginal dilators. Counseling or therapy may also be recommended to address any emotional or psychological factors that may be contributing to the condition.
It is important to note that not all treatments will work for every individual, and it may take some trial and error to find the right approach for managing vestibulodynia. With the right treatment plan, it is possible to manage the symptoms of vestibulodynia and improve your quality of life.
Medications for vestibulodynia: Topical and oral
There are different types of medications available to treat vestibulodynia, both topical and oral. The choice of medication depends on various factors such as the severity of the pain, the patient’s medical history, and their response to previous treatments.
Topical medications are applied directly to the vulvar area and can include local anesthetics, such as lidocaine, or hormone creams. These medications temporarily relieve pain by reducing inflammation and numbing the area. Hormone creams can help normalize the hormonal milieu if there is a hormonal cause of the vestibulodynia.
Oral medications, on the other hand, are taken by mouth and can include antidepressants. These medications work by altering the way the brain processes pain signals. However, it may take several weeks to see the full effect of these medications and they may also cause side effects.
Vaginal suppositories of muscle relaxants or anxiolytics can also help acute symptoms.
It’s important to note that medication alone may not be enough to effectively manage vestibulodynia. It’s often recommended to combine medication with other treatments such as physical therapy, relaxation techniques, and changes in sexual practices. It’s also important to work closely with a healthcare provider to find the best treatment plan for each individual case.
Physical therapy for vestibulodynia
The goal of physical therapy is to help patients achieve pelvic floor muscle relaxation, reduce pain, and improve sexual function. The therapy may include pelvic floor muscle relaxation exercises, biofeedback, and dilator therapy. Pelvic floor relaxation exercises involve the patient learning how to consciously relax their pelvic floor muscles. Biofeedback is the use of sensors to monitor muscle activity and provide feedback to the patient, enabling them to improve their muscle relaxation technique. Dilator therapy involves the use of vaginal dilators to stretch and desensitize the pelvic muscles.
Physical therapy is usually done in conjunction with other treatments for vestibulodynia, such as medication. The therapy may take several weeks to months to show significant improvement, and patients are advised to continue with the exercises even after experiencing relief from symptoms.
It is important to note that physical therapy for vestibulodynia should only be done by a qualified and experienced pelvic floor physical therapist, as improper technique could worsen the condition.
Alternative treatments for vestibulodynia
While traditional treatments for vestibulodynia, such as physical therapy and medication, can be effective, there are also alternative treatments that can help manage symptoms and provide relief. Some women have found relief through dietary changes, such as eliminating foods that may trigger inflammation or sensitivities.
Coping with vestibulodynia: Emotional support and self-care
Coping with vestibulodynia can be challenging both physically and emotionally. It is important to acknowledge the impact that chronic pain can have on your mental health and well-being.
Having a supportive network of family and friends can be a great source of comfort and encouragement.
Self-care is also an important aspect of coping with vestibulodynia. This can include activities such as meditation, yoga, or gentle exercise. It is also important to prioritize rest and relaxation to help manage stress and pain.
