Learn more about what could cause vaginal pain and how to treat it. Vulvodynia is a chronic condition that involves pain, burning or discomfort in the vulva, that can’t be attributed to any specific cause, and that lasts for at least three months.
Vulva is the part of a woman’s body that protects the genitals. It includes the external female genitalia, including the mons pubis, the labia majora and minora, the clitoris, and the perineum. It can affect women of all ages, although vulvodynia generally occurs between the ages of mid 20s to 60s. It’s estimated that around 15% of women will experience the condition in their lifetime.
The most common symptom is a painful, raw or burning or stinging sensation. Some women describe it as a ‘knife-like’ pain or as if acid is being poured on their skin. Pain may be constant or it may come and go, or only occur with pressure or contact. Other symptoms may include throbbing, itching or rawness. Most sexually active women will report that sex is painful or impossible.
Symptoms also include: pain with pressure or touch to the vestibule while having sex or inserting a tampon, sitting for prolonged periods of time, wearing tight pants, during exercise such as bike riding or walking, and, in some women pain can occur while urination. The pain can affect a particular spot, or it may be felt in a wider area, including the clitoris, the perineum, the mons pubis, and the inner thighs. It can also affect the area around the urethra and the top of the legs and inner thighs.
There is no specific test to determine whether you have vulvodynia. Diagnosis involves ruling out other causes. Your doctor will ask about your medical, sexual and surgical history and about the kind of symptoms you have. Your doctor may also perform a pelvic examination to look for infection or other causes of your symptoms. They may also take a sample of cells from your vagina or vulva to test for bacterial or yeast infections. Your doctor might also check your pelvic floor muscles to make sure they are not tight, contracted and painful to touch.
Vulvodynia can impact on intimate relationships and psychological well-being, including increases in depression, anxiety, and lowered self-esteem. Social constructions around sex and womanhood also exacerbate psychological difficulties by increasing shame, silencing, and guilt at not being able to “perform as a woman,” which in turn leads women to feel de-gendered and no longer “a real woman”.
If you have vulvodynia, don’t let the absence of visible signs or embarrassment about discussing the symptoms keep you from seeking help. Treatment options are available to lessen your discomfort. And your doctor might be able to determine a cause for your vulvar pain, so it’s important to have an examination.
Some types of vulvar pain get better with creams or pills made to treat yeast infections. Sometimes the pain goes away if you use creams that contain estrogen or cortisone. But cortisone cream isn’t good to use for long periods of time. Some antidepressant medicines can help nerve pain and irritation. Other treatments that may help include interferon injections, laser therapy, or surgery.
Muscle spasms in your pelvic area can also make vulvar pain worse. Physical therapy or biofeedback treatments, that help you strengthen and relax your pelvic muscles, may help ease the spasms. If you decide to try one of these treatments, look for a therapist trained in women’s health.
With practice, you can learn to relax your tissues in your pelvic muscles with exercises you do at home to release tension in muscles and joints.
Some others measures can be taken that do not involve medications. If vulvodynia occurs, the first step is to stop using any irritants, such as perfumed soaps. But there are other things you can try to relieve your symptoms:
Always clean your vulva gently, avoid soaps and other products, such as vaginal sprays or douches that irritate your skin.
Wear loose-fitting cotton clothes. Avoid nylon and other fabrics that hold moisture close to the skin. This may cause irritation and allow an infection to start.
Avoid hot baths, and don’t use soaps or bath products to wash your vulva. Rinse with water only, and gently pat the area dry.
A change in menstrual products might help, for example, switching from synthetic to cotton-based items.
Relieve itching and pain with a cold water compress or cool baths. Don’t scratch the area.
Try using a vaginal lubricant to reduce irritation from having sex.
Since stress can play a role in vulvodynia, either as a trigger or a consequence, stress management may help ease symptoms. Acupuncture and cognitive behavior therapy are options currently being explored. Practice relaxation and breathing exercises. Meditation and guided imagery are two examples of how you can reduce stress and relax your mind and muscles.
