Vulvodynia and Vestibulodynia
Pain at the vulva (the external genitalia) can have many causes but today I am writing about just one of the common types of pelvic pain: Vulvodynia.
So what is it?
Vulva pain that has been around for 3 months or more that doesn’t have a clear cause such as an infection or trauma. So basically, when you are having ongoing vulva pain that can’t be explained by anything else we call it this.
Vulvodynia can be generalised (the whole external genitalia) or specific, like Vestibulodynia (when pain is only at the vestibule).
Women may experience pain, discomfort, burning or stinging. This type of pain or discomfort is often bought on by physical contact, for example vaginal penetration, tampon insertion or even just the touch of clothing on the area. Vestibulodynia occurs in 3-18% of women.
Although it isn’t fully understood why some women get vuvldodynia and vestibulodynia, there are many factors associated with it. For example the combined hormonal contraceptive can increase the chances of having this condition. The pelvic floor muscles are often “overactive” or “tight” contributing to the pain experienced with vulvodynia.
What can you do about it…?
- First it is important to check in with a GP or Gynaecologist to determine if there are any other causes that could explain your vulva pain (check for things like UTI, dermatitis or STI’s).
- Lubrication – sometimes something as simple as using good lubrication can reduce pain
- A GP or Gynaecologist might prescribe certain medications that help to reduce the sensitivity of the nerves in the area. This is because it has been shown women with vulvodynia have more nerves and receptors in the vulval tissue that can result in feeling pain in response to things that aren’t normally painful.
So what does it have to do with physio…?
Often the pelvic floor muscles are involved because when we are in pain, muscles like to contract to try and protect us. When you think about it, if we get pain everytime something trys to touch or enter the vagina, naturally the muscles in the area are going to want to tighten up to protect and stop anything trying to enter the area.
This might be helpful if we have a UTI and everything in the area is irritated. The muscles tighten up to protect against things from entering until the inflammation and irritation settles down.
BUT when someone is in pain for a long time, the muscles might stay in this protective mode for too long.
This can result in the muscle becoming tight (not being able to stretch very much to let something inside) or the muscle might be overactive (doesn’t know how to switch off).
This is where physiotherapy may help. There are a number of therapies commonly used
- Electrical stimulation: to calm the sensory nerves in the area
- Pelvic floor muscle down training: learning to contract or more importantly relax the muscle
- Relaxation exercises
- Manual therapy: such as massage techniques to reduce the tender points in both internal muscles such as the pelvic floor muscles or external muscles around the pelvis and lower back
- Dilators: can help to stretch the tissue of the vagina.
What each patient needs is always individual, some people will only need one of the above, while others would benefit from a combination of the above.
Disclaimer: This information is general advice only; If you are experiencing vulva pain it is important to check in with your GP or Gynaecologist for diagnosis and to rule out any other causes of vulval pain such as UTI, dermatitis or STI’s.
*Image credit: WIKIMEDIA