What Should You Know About Vestibulodynia?

Vestibulodynia is defined as ill-defined discomfort in vulva. This condition is characterized by symptoms such as pain in the vulval region whenever any physical pressure is applied. Women may also experience inflammation, burning, and/or itching along with sexual discomfort. However, severity and frequency of symptoms varies from woman to woman.

Vestibulodynia was previously referred to as Vulval Vestibulitis due to site of discomfort i.e. vestibule. Vestibule is the inside part of the inner vaginal lips. The vestibule area possess urethra (urine carrying tube), Bartholin’s gland (gland that lubricates vagina) and vestibule glands – i.e. glands that are responsible for vaginal lubrication via secretions. This condition usually affects sexually active women, especially those who are between 20 and 40 years of age. It is imperative to keep in mind that older women may also get affected. There are two clinical varieties of Vestibulodynia;

• Primary Vestibulodynia: In this form, women complaints of pain since first sexual encounter.
• Secondary Vestibulodynia: The secondary form occurs in women after a fairly comfortable sexual life.

What Are Classic Symptoms Of Vestibulodynia?

The hypersensitivity at the vulval region not only makes your sexual encounters unpleasant or painful, but can also greatly affect your day-to-day non-sexual activities. For example, moving around wearing tight clothes can be burdensome and painful for such women. Even walking or sitting for several hours can be unbearable. Usually these discomforting symptoms lasts for 3 to 6 months but some women may suffer for years.

What Causes Vestibulodynia?

Research suggests that symptoms of Vestibulodynia are a result of over growth or increased sensitivity of nerve fibers located in the vulva or vestibule region. Following risk factors can greatly aggravate the risk of this disease:

• Injury in the vulval region due to surgery or child birth
• Hypersensitivity towards detergents or panty liners can also leads to vestibulodynia.
• Thrush, a chronic yeast infection can also aggravate this condition.
• Other than this, a history of sexual abuse is also frequently associated with this condition.

Though, vestibulodynia is a real problem but, it may partially be a result of psychological issues.

How To Diagnose Vestibulodynia?

As part of the diagnostic process, doctors perform comprehensive examination of vulval area to rule out other possible conditions such as infections. Patient might be referred to a gynecologist for more specific diagnosis. Pressure is applied at vestibular area to point out the exact location of pain. This condition can be mistaken for thrush because sometimes there are no noticeable symptoms except redness. However, a swab testing can rule out this doubt.

How To Treat Vestibulodynia?

Following are some treatment modalities that can help in managing the symptoms of this condition:

• Vaginal dilators: Insertion of vaginal dilators relaxes the muscles surrounding the vaginal canal and ease the symptoms during sexual activity.
• Anesthetic gel: Lidocaine or any other anesthetic gel can be applied before sex to desensitize the nerves.
• Pelvic floor muscle physiotherapy: This therapy or exercise is helpful in relaxing the vulval region.
• Antidepressants: Amitriptyline or other oral anti-depressants are also prescribed for treating vestibulodynia.
• Corticosteroids: Depending upon the condition, doctor may prescribe corticosteroids to relieve discomfort.
• Surgery: Though it is rarely suggested but it is effective in some patients.

Vestibulodynia is a complicated condition which makes diagnosis and treatment fairly difficult. Since, this condition has negative influence on the sex life; it is important to consult a psychosexual therapist as well. Non-penetrating sexual activities have proven to be beneficial in boosting the confidence and intimacy levels. Along with doctors and therapists, it is also vital to communicate with partner in order to explore better options for maintaining the intimate connection.

References

• Lahaie, M. A., Amsel, R., Khalifé, S., Boyer, S., Faaborg-Andersen, M., & Binik, Y. M. (2015). Can fear, pain, and muscle tension discriminate vaginismus from dyspareunia/provoked vestibulodynia? Implications for the new DSM-5 diagnosis of genito-pelvic pain/penetration disorder. Archives of sexual behavior, 44(6), 1537-1550.
• Bois, K., Bergeron, S., Rosen, N. O., McDuff, P., & Grégoire, C. (2013). Sexual and relationship intimacy among women with provoked vestibulodynia and their partners: Associations with sexual satisfaction, sexual function, and pain self‐efficacy. The journal of sexual medicine, 10(8), 2024-2035.