Vestibulodynia- Pain at the Opening of the Vagina
Okay guys! So we often talk about how pain *down there* is not normal. Of course, there are a lot of possible causes — including certain medical diagnoses like endometriosis, just having had a baby or a general imbalance of the pelvic floor muscles (whether too tight or too loose). However, I think that there is a big misconception about what pelvic floor pain means. We tend to think of it as being *inside* the pelvic girdle – but this may not always be the case…
Vestibulodynia is chronic pain or discomfort that occurs around the opening to the vagina: the vestibule is where the lips of the vulva meet your vagina. It is a very sensitive part of your body and contains multiple glands to help with lubrication/discharge as well as the urethra. Pain may occur when the area is touched, during sex, when using a tampon or other certain movements like prolonged sitting. The area may even be chronically red and inflamed.
The exact cause of vestibulodynia is not yet known, though the disease was discovered by American gynecologist Edward Friedrich in 1987. There are some predisposing factors that may make vestibulodynia more likely:
Chronic yeast infections
Injury or trauma (like childbirth)
Skin sensitivity to certain dyes, soaps or detergents
Genetics
Hormones
Certain allergies
The symptoms of vestibulodynia include:
Burning pain with touch, during sex or tampon insertion
Pain with repetitive activities such as bike riding or jogging
Red, inflamed skin
Pain with tight clothing
Dryness or rawness
Itching is not usually a problem
There are no visible symptoms of vestibulodynia. Your healthcare provider will make the diagnosis based on a thorough history and physical/pelvic exam. The goal of treatment is to decrease pain and discomfort, though this may take time to figure out what combination works best. Lifestyle changes like including avoiding tight clothing, changing your soaps and detergents to hypo-allergenic/organic, and using lubrication for sex might be a good place to start. Other forms of treatment could include local anesthetic creams, medication, biofeedback and pelvic floor PT, vaginal dilators and (as a last case scenario) surgery.
Usually a multi-modal approach is the best way to address vestibulodynia. But the most important thing to know that pain on the outside is not normal — and you don’t need to suffer with it. Getting in to your healthcare provider as soon as possible is an important first step! And of course coming to see a PFPT can also help!
<3 The RPT Team
https://www.rechargedperformancetherapy.com
(321) 802-1630
References
https://my.clevelandclinic.org/health/diseases/23514-vestibulodynia