Vulvodynia / Vestibulitis

Alternative Names: The term is also used to refer to vestibulitis or Vulvar Vestibulitis Syndrome (VVS), which is an inflammation of the vestibule, or opening into the vagina and the tissues immediately around the vaginal opening.  This condition is sometimes also called 'vestibular adenitis'.

Vulvodynia is a medical term that means 'painful vulva'.  The term can cover a wide variety of vulvar pain syndromes including various infections and skin disorders.

Causes and Development

Some cases of vulvodynia may be due to compression or disease of the pudendal nerve, one of the main nerves that relays sensation to and from the genitals.

Signs and Symptoms

In mild cases, a burning or stinging sensation is noted during intercourse or when tampons are inserted.  Upon touching the area with a cotton swab, pain is felt when the hymen and inner vaginal lips are touched.  There also may be redness and swelling.  In severe cases, the pain can be agonizing and much of the vulvar can be reddened, swollen and very inflamed.  Often the edges of the inner vaginal lips are very sensitive and the pain so severe that it makes walking difficult.  There may be a constant itching or stinging sensation in the grooves between the large and small vaginal lips.  Wearing underwear may be very uncomfortable as the slightest touch to the area may result in excruciating pain.

Other signs include pain or discomfort upon touching the pubic hair, over the vulvar skin or in certain spots.  These sensations may extend to the rectal area or skin of the perineum.  The clitoris can become involved, becoming painful or hypersensitive and there may be shooting pains from the clitoris up the abdomen.  Sexual intercourse and urination may be very painful.

Treatment and Prevention

Some women need to avoid underwear that irritates the area or avoid using underwear altogether.  If you must wear pantyhose or stockings for work, wear brands with a cotton crotch over the all-cotton underwear and slit the pantyhose crotch to relieve binding, or use old fashioned garter belts and stockings.  Additionally, during your menstrual period, if you cannot tolerate a tampon string, you may cut off the string prior to insertion.  If menstrual pads are too painful, you may use rolls of absorbent cotton.

Vulvar pain due to skin conditions such as dermatitis, lichen sclerosis may be relieved with topical corticosteroids.  Compresses made from prophyllin powder may provide soothing relief.

Prognosis

In a few people vulvodynia clears up on its own after 6-12 months.