Vestibulodynia, vesti... what?

What is it?

Vestibulodynia, also called vulvar vestibulitis, is a dyspareunia that manifests in women with pain directly related to pressure in a specific region of the vulva. It can appear as pain, discomfort, burning and tearing sensations. These effects are also felt during penetrations, the insertion of a tampon or a speculum gynecological examination. This type of condition, which is defined as chronic pain, affects between 12% and 15% of middle-aged women.1 In addition, some women suffer even if the pressure is not direct or intentional, like riding a bike or a horse, or just by wearing tight clothing and underwear.

 

 

Where is that from?

Nowadays, the causes and the origin of this dyspareunia are still unknown. We do know that it is a chronic pain, that this condition is not contagious and that it is not a sexually transmitted disease.

 

 

What are the symptoms?

The symptoms are perceived and manifested in different ways with women who have them, since each case is different. However, there are three types of more common symptoms:

  • Acute pain with slight or pronounced pressure on the vulva.

  • A burning or tearing sensation when inserting an object or during penetration.

  • A slight redness localized in the affected area.

 

 

How is the diagnosis made?

What you need to know is that this condition has few visible physical symptoms. It is very important to talk to a health professional since it is usually a big source of anxiety for women. Stress can be caused by fear of pain (or worry) that you can not be sexually or physically active. Unfortunately, if the affected woman does not talk about the pain she feels, she will not be able to receive a proper and appropriate examination to diagnose a vestibulodynia.

 

 

What are the repercussions of vestibulodynia?

  • Anxiety regarding pain, especially when this pain is unknown or misunderstood. 

  • A drop of libido that can sometimes be combined with a feeling of shame.

  • A loss of intimacy through a decline or lack of self-confidence.

  • Sexual frustration directed towards yourself or a partner.

  • A feeling of personal blame that can lead to depression.

  • Tensions in the relationship that can lead to a breakup.

 

What are the treatments?

  • Therapy with a sexologist or psychologist is strongly recommended to help with anxiety, depression and lack of self-confidence. Inquiring and having information about this condition can help you get through this painful step more easily. It is important to be patient and to have as much support as possible since vestibulodynia can take a long time to heal.

  • Pelvic rehabilitation with the help of a physiotherapist is a very conceivable solution for a gradual return to an active sex life. This treatment must be done over a long period of time, but allows satisfactory results. Dilators are regularly used to strengthen the pelvic floor muscles in a gradual and safe manner. In addition to having a ring for an easy handling, Floravi's dilators are made of high quality silicone and their curved tips allow for an easy and gradual insertion. The set includes 4 dilators of different sizes and diameters to promote progressive training and rehabilitation. It is strongly recommended to start this treatment with the help of a professional to ensure optimal comfort when pursuing treatments alone at home.

  • According to the pain felt, taking certain medications can also help you. Lidocaine can be used as a local anesthetic in the affected area to reduce pain. Cromoglycate, often used as an antihistamine, can also help reduce redness and inflammation. This is the same process as fighting an allergic reaction. This type of treatment is often considered when someone wants to return slowly to sexual intercourse without fear of pain during the penetration. Since these medications have some mild side effects, such as drowsiness or complete lack of sensation, they can cause sexual dissatisfaction.

  • Minor surgery (a single day of hospitalization) called vestibuloplasty may also be considered as a last resort. It involves removing a small portion of the hymen and vestibule. However, this treatment is not available for all women. In fact, it is generally suggested to women who are in good mental health and who do not show signs of anxiety related to vestibulodynia. In addition, following surgery, you must be ready to participate in therapies with a psychologist, a convalescence of two to four weeks and a complete absence of sexual intercourse with penetration for a period of three months. The use of dilators is appropriate for the months following this minor operation in order to progressively rehabilitate the region in anticipation of future insertion or pressure (tampon, penetration, touch, etc.).

 

Sources :
1Coup de pouce, MERCK, Canal Vie
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