Sunshine Clinic
The Private Health Clinic
Vulvodynia & Vestibulitis
What is Vulvodynia & Vestibulitis ?
Vulvodynia
Vulvodynia is encountered mainly in post-menopausal women. It is defined as chronic soreness, burning or pain in the vulval area, which can get worse at night. It is associated with itching in the vulval area and usually accompanied by a red rash. It is a diagnosis of exclusion when other conditions have been ruled out and is claimed to be one of the most common conditions seen in clinics. Sometimes there is no obvious reason for the pain and the pain may persist after treatment. Occasionally vulvodynia and another condition called vulval vestibulitis may have some overlap. Vulvodynia is sometimes misdiagnosed, therefore a thorough evaluation, review of patient history and a clinical examination is necessary from a specialist Doctor with experience & understanding of vulval conditions.
Vestibulitis
Vestibulitis is a condition which causes redness and pain of the vestibule or inflammation of the skin and mucous secreting glands in this area. Vulval vestibulitis is sometimes described as a syndrome in which there is pain at specific points in the vulvar vestibule, which is the area surrounding the entrance to the vagina. It can occur in women of all ages, including those who are sexually active and those who have never been sexually active. Many women with this problem may have suffered both physically and emotionally for months or years. They have usually tried many different treatments in search of relief.
Diagnosis of Vulvodynia & Vestibulitis
Vulvodynia
Vulvodynia is diagnosed by clinical examination, and is often described as unexplained vulvar pain, frequently accompanied by:
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physical disability
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limitation of daily activities
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sexual dysfunction
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psychological disability
Symptoms can involve the onset of short and relatively severe vulva pain, with episodes of vaginitis, or recurring vulval pain lasting months or years. Frequently the vulval pain has been described as burning, stinging, or a feeling of rawness or irritation.
Vestibulitis
The signs and symptoms of vestibulitis include:
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severe pain due to pressure, for example, cycling, exercise, wearing tight clothes
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discomfort on vaginal entry either when using a tampon, or during intercourse
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burning, stinging, irritation, or raw sensation within the vestibular area
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vestibular redness
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the urge to urinate frequently or suddenly
Diagnosis will involve a clinical examination by the Doctor, swabs may be taken from the vaginal area and tested for thrush, as reoccurring thrush is known to be a causative factor of vestibulitis. Although the cause of vestibulitis is unknown, the following factors have been associated with the condition.
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recurring yeast infections
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recurring bacterial infections
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chronic changes of the PH (acid balance) in the vagina
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repeated use of chemicals/irritants such as detergents, soaps, spermicides lubricants
Treatment of Vulvodynia & Vestibulitis
Vulvodynia
Treatment may involve tests for fungal infections, and even if tests are negative, long term anti-fungal treatment, with both oral and topical creams. Other treatments may include changes in diet, or treatment for vaginal muscle spasm, and laser therapy. Vulvodynia may cause alterations in lifestyle, for example it may decrease the ability to exercise, sit for long periods, or participate in sexual activities. Many women become angry and anxious because of a lack of physical findings, and worry that they will never recover. Treatment may involve taking anti-depressants, also support and counselling may be needed to help manage the condition. The Doctor may prescribe a medication, for example drugs such as amitriptyline, or anti-epileptic drugs in low doses.
Vestibulitis
Treatment may involve the following:
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Anti-fungal treatment, either tablets, pessaries, or creams
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Steroid Ointments (caution is recommended, only use as prescribed by the Doctor)
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Chemicals may be used in some cases
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Injections may be given to increase the body's response to infections
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Surgery or Laser treatment may be used to remove affected skin areas
There are many different helpful hints which the Doctor can discuss at consultation following appropriate examination and diagnosis.
