Vestibulitis

General information about vestibulitis

Vestibulitis, also known as vestibulodynia or vulvodynia, occurs mostly in women between the ages of 15 and 30 who have not yet had a vaginal birth. The pain can be so severe that everyday life is severely impaired and it causes physical and mental discomfort. As a result, this can lead to relationship problems, a reduced desire for sex , fear during sexual intercourse and the worry of not being able to have a child. These conditions can affect your overall quality of life.

There is seldom a single explanation for the occurrence of vestibulitis and for a long time, even within medicine, knowledge of the condition was very poor. Besides the tenderness in the vaginal opening and the feeling of pain and burning in the lower abdomen, vestibulitis does not cause any clear physical symptoms. Therefore, this type of pain has not been adequately considered, diagnosed or treated in the past. Today there is more knowledge about it and there are better ways to alleviate the problems.

It can be difficult to talk about vaginal pain. Therefore, many prefer to endure the pain rather than tell others about it. But if you have abdominal pain, you absolutely must see a doctor who can really help you. Without treatment, the pain caused by vestibulitis can keep coming back and even get worse for many years.

Symptoms of Vestibulitis

Vestibulitis causes pain in the vaginal opening. The pain is often intense and can be biting, burning or cutting. They can be very strong and you may experience pain throughout the vagina, both in the vaginal wall and around the vagina.

For some, the symptoms of vestibulitis only appear during sexual intercourse, when the penis penetrates the vagina, or when, for example, a tampon is inserted into the vagina. Others experience permanent pain, which is very annoying when cycling or horseback riding. With severe vestibulitis, even light touching or various movements can hurt. Then there is already pain when squatting, sitting down or when wearing clothes that fit tightly on the abdomen.

Usual Symptoms:

• severe pain in the vaginal opening
• Redness in the vaginal opening
• Abdominal pain on pressure and touch
• pain during sexual intercourse
• Restlessness and anxiety associated with the pain.

Those who suffer from vestibulitis are often also affected by vaginal spasms, known as vaginismus .

Other possible explanations

Vaginismus (vaginal spasm) can have symptoms similar to vestibulitis. But it is mainly characterized by muscle spasms that make it impossible to insert anything into the vagina. Long-term problems with recurring yeast infections can also lead to vaginal pain.

Endometriosis often causes severe pain during sexual intercourse, but is usually strongly associated with menstruation and is also characterized by abdominal pain and urinary tract problems. Atrophic vaginitis causes dry mucous membranes in the vagina. This can cause pain during sexual intercourse, but this is solely due to the dryness and is not as long-lasting and severe as in vestibulitis.

Generalized vulvodynia (vulvar pain) is a painful condition in the vagina that primarily affects older women. Symptoms are similar to vestibulitis, but the pain is permanent from the start and is not associated with vaginal penetration. There are other explanations for abdominal pain. An examination by the gynecologist is often necessary to determine where the pain is located and what treatment is necessary.

Causes of vestibulitis

With vestibulitis, the nerves at the vaginal opening have become particularly sensitive. There is no clear explanation for the pain.

A previous pain condition can be a triggering factor, which is then stored as a memory in the body. This can be painful sexual intercourse, for example, where the vagina was particularly dry or the mucous membrane was particularly sensitive. If you experience pain when penetrating the penis, this can lead to muscle tension during the next intercourse and cause recurring pain problems.

Triggering factors that can make the mucous membrane sensitive and cause pain:

• recurring fungal infections
• Antibiotics
• Sex without you being excited and wet
• excessive drying
• Contraceptives with hormones such as the birth control pill or hormone spiral.

Other pain conditions, psychological issues, and severe stress can also be precipitating factors for vaginal pain.

Investigations and treatment of vestibulitis

Abdominal pain should always be evaluated by a doctor. To be sure that it is vestibulitis, you need to have an examination by your gynecologist and tell them about your symptoms – how you perceive the pain, when it occurs and how it is getting worse. If it is difficult to determine what is causing your discomfort, or if you are in particularly severe pain, you can visit special vaginal care units located in various hospitals across the country.

Vestibulitis is defined as a protracted painful condition lasting at least six months. There is no medication that can cure vestibulitis, but a combination of treatments can often relieve symptoms and make you symptom-free. For example, stopping hormonal birth control, using a numbing gel, and doing muscle-relaxing exercises with a physical therapist can help.

Sexual counseling, talk therapy and cognitive behavioral therapy (CBT) can also help to deal with the symptoms more easily. Sometimes antidepressants at a low dose can help with pain symptoms such as vestibulitis.

Botox is a muscle relaxant, and injections into the muscles around the vagina appear to reduce pain. However, this is a new form of treatment that is still being studied. If the vestibulitis is very severe, it may be necessary to remove a small portion of the mucosa near the vaginal opening.

what you can do yourself

If you have vestibulitis, you should avoid anything that can unnecessarily irritate the lower abdomen. Wash only with water and not too frequently, add moisture, and avoid intercourse when in pain. Don’t use over-the-counter antifungal medications – they can worsen your symptoms and make the lining of the vagina even more sensitive.

When you have sex, you should share your discomfort so that your partner understands that it can be painful for you when he penetrates you.

Here’s how you can relieve your symptoms:

• avoid soap when washing your abdomen – only use water
• Remember that water is drying – don’t use too much water and apply some baby oil to the vaginal wall before you shower
• introduce extra moisture into the vagina – petroleum jelly, a fatty ointment and children’s oil can relieve the pain
• use hygiene products that don’t come into contact with the vaginal wall – pads are a better alternative than tampons and menstrual cups
• avoid topical antifungal medications – they can make the mucous membrane even more sensitive
• avoid penile sex if you are in pain – otherwise the symptoms may worsen
• use a lubricant during sex to protect the mucous membrane
• try hormone-free contraceptives – hormones make the mucous membrane sensitive
• Try to reduce stress – Stress can make symptoms worse and contribute to muscle tension.
• train your pelvic floor – when you have better control of the muscles in the pelvic floor, it becomes easier to relax
• do relaxation exercises – Research shows that yoga and mindfulness exercises, for example, can have a positive effect.

When to seek medical help

All types of abdominal discomfort should be taken very seriously and you must always see a doctor if you experience pain. A condition that is left untreated can lead to vestibulitis, and vestibulitis that is left untreated can itself lead to an even more painful condition.

Visit a doctor’s office if you experience pain associated with vaginal intercourse or if it hurts when you insert something into the vagina, such as a menstrual cup or tampon.

Here’s how Med-Healths can help you

A physical exam is required to diagnose vestibulitis. But you can contact us at Med-Healths if you need advice and information. A doctor makes an individual assessment based on your symptoms and the findings of the examination. You can then be referred for further medical care.