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Urogynecology

Vulvodynia and Vulvar Vestibulitis

Vulvodynia is a condition associated with pain in the opening of the vagina. This includes tenderness and profound burning. Vulvar vestibulitis is a related condition marked by redness and inflammation in the vaginal opening.

The cause of these conditions is not understood. Increased sensitivity of the nerves on the skin's surface may contribute.

Women of all ages experience vulvodynia and vulvar vestibulitis. Those who have interstitial cystitis, endometriosis and high-tone pelvic-floor muscle dysfunction appear susceptible, but it is unclear whether these diseases trigger vulvodynia and vulvar vestibulitis or vice versa. Menopause, stress and changes in detergent, soaps or other hygiene products also seem to trigger vulvodynia and vulvar vestibulitis.

What are the symptoms of vulvodynia and vulvar vestibulitis?

The severity of symptoms can range from mere irritation to incapacitating pain in the vulva, which is made up of the skin and underlying tissue at and around the opening of the pelvic organs. Classic complaints include:

  • Chronic pelvic pain that is aggravated by tight clothing and contact with the vulva.
  • Painful sexual intercourse.
  • Burning with urination.
  • Vaginal burning.
  • Inability to wear certain clothing, particularly tight clothing.
  • Inability to tolerate sanitary pads.

Patients also might feel like they are experiencing recurrent bladder infections, with symptoms such as burning during urination, frequent urination and a strong urge to urinate. However, if they have vulvodynia or vulvar vestibulitis, a lab test will show no infection-causing bacteria in their urine.

They also may develop other pain conditions, such as pelvic floor muscle dysfunction, interstitial cystitis, irritable bowel syndrome, endometriosis and fibromyalgia.

Because patients with vulvodynia or vulvar vestibulitis experience many different pain conditions, they sometimes see multiple doctors for treatment. Our doctors have the training to identify these various conditions and offer a spectrum of treatment options.

How are vulvodynia and vulvar vestibulitis diagnosed?

Vulvodynia and vulvar vestibulitis are mainly diagnosed through a review of your family medical history and a physical exam. The exam includes the doctor touching different parts of the vulva with a cotton swab to identify pain triggers. Vulvar vestibulitis is diagnosed when a patient has a positive touch test and redness at the opening of the vagina.

How are vulvodynia and vulvar vestibulitis treated?

There are many treatment options, and a combination is often necessary. Options include:

  • Medication. Many medications are available, including oral varieties and topical creams. Some treat specific conditions such as inflammation and atrophy. Sometimes drugs are combined into special formulas to treat multiple symptoms.
  • Managing behavior. Sometimes, changing simple things can control your symptoms. This could include using hypoallergenic detergents and soaps, wearing cotton underwear and other breathable clothing, and avoiding tight-fitting garments.
  • Strengthening the pelvic floor muscles. A physical therapist specializing in these conditions can teach you techniques to improve symptoms. Therapy includes techniques to help you relax and re-establish normal posture and body mechanics. A variety of exercises may be necessary, but results are excellent.
  • Modifying your diet. Minimizing bladder irritants in your diet can improve symptoms. Common culprits include alcohol, caffeine and artificial sweeteners. Dietary changes can be tailored to your needs but are important in managing these conditions.
  • Treating related conditions. Treating other medical problems that are occurring with vulvodynia and vulvar vestibulitis can improve recovery.
  • Other options include injection therapy and surgery.

Christiana Care Center for Urogynecology and Pelvic Surgery

Three Locations:

Christiana Hospital
Medical Arts Pavilion 2
4735 Ogletown-Stanton Road, Suite 1208, Newark, DE 19713 directions
302-623-4055
fax 302-623-4056

Christiana Care Concord Health Center
161 Wilmington-West Chester Pike, Chadds Ford, PA 19317 directions
610-361-1030

Christiana Care Center for Women's Health
3706 Kennett Pike, Greenville, DE 19807 directions
302-623-4055

Smyrna Health & Wellness Center
100 S. Main Street, Suite 215
Smyrna, DE 19977 directions
302-623-4055

Delaware Health Sciences Alliance CarePages Magnet recognition for excellence in nursing

Christiana Care is a private not-for-profit regional health care system and relies in part on the generosity of individuals, foundations and corporations to fulfill its mission. To learn more about how you can support our mission, please visit christianacare.org/donors.

Christiana Care Health System PO Box 1668, Wilmington, DE 19899 800-693-CARE