Vulvodynia & Vestibulodynia

Vulvodynia is a condition when there is persisting or recurring pain around the opening of the vagina (vulva). Vestibulodynia is a condition, when it hurts at the opening of the vagina on application of pressure.

In case of Vulvodynia, due to the pain and burning sensation, sitting for longer periods or having sex becomes a nightmare. This pain can last for several weeks to months. You must see your urologist if the pain is persisting for more than a week, so that early treatment can give you quicker relief. Consult a good urologist near you and discuss the problem openly so that the problem can be diagnosed and appropriate treatment can be started immediately.

Vulva - Pain on outer surface of vagina, urologist for treatment

Symptoms of Vulvodynia

  1. Burning at the opening of vagina
  2. Soreness
  3. Stinging & itching like sensation
  4. Painful intercourse
  5. Throbbing

Note that the pain may be localized in a particular spot of the vaginal opening or it can be around many parts of vagina (vulvar region).

What can cause Vulvodynia:

While the exact causes of vulvodynia are not known, following are some possible causes:

  1. Injury to or irritation of the nerves in the vulvar region.
  2. Vaginal infections.
  3. Allergies (to your under pants or cloth that you are wearing) or the skin may have become sensitive.
  4. Hormonal Changes (can happen during menopausal state)
  5. Muscle spasm or weakness in the pelvic floor region.

Complications

Because of the pain, having sex can become a nightmare. Abstinence from sex can lead to emotional issues between you and your partner. Other complications can be

  1. Depression
  2. Anxiety
  3. Disturbed sleep
  4. Sexual Dysfunction
  5. Decreased quality of life.

Diagnosis

Before begining the examination, a good urologist should question about your daily activities, sexual and surgical history, your hygine habits to understand some obvious reasons of the problem. He/she may also perform a pelvic exam and/or cottom swab test.

Pelvic Exam: The urologist examines your vulva and vaginal area for obvious signs of infection. Fluids inside vagina may be collected for testing.
Cotton Swab Test: A soft cotton swab is used to apply pressure on the vulvar region to determine the exact location of pain.

Discuss your problem openly with your doctor so that he/she can rule out any simple causes such as yeast infection or bacterial infections, herpes, pre-cancerous skin or diabetes. Do NOT take any offline medication on your own as this can complicate the problem.

Treatment of Vulvodynia & Vestibulodynia:

Different approaches may be taken depending on the diagnosis by your doctor. A combination of treatments may work for some. Treatment options include:

  1. Medication: Steroids, anti-depressants, pain killers may be prescribed. Anti-histamine medicine may be given for treating itching or irritation.
  2. Biofeedback therapy: Your urologist will teach you how to relax your pelvis when the pain starts.
  3. Local anesthetics: Ointments will be prescribed that should be used 30 minutes before intercourse. This numbs the area and lessens the pain felt during the sexual act.
  4. Nerve blocks: for those with long standing pain, nerve block injections may be administered.
  5. Pelvic Floor Therapy: Exercises will be taught to relax pelvic muscles that can help in relieving pain.
  6. Surgery: If the skin on the vulva is affected /infected and if removal is an option to get rid of the pain, your doctor may perform a surgery to gid rid of the kin on the vulva or around it.