Do I have Vaginismus or Vulvodynia?

[Heather34]

From Dr. Pacik: “Currently, the default diagnosis of sexual pain is vulvodynia. That means that when a physician is faced with a patient who is unable to have intercourse because of pain, the diagnosis is automatically vulvodynia or “vestibulitis” Very few clinicians think of asking about vaginismus and therefore most of my patients have been misdiagnosed as suffering from vulvodynia, when in actual fact the correct diagnosis was vaginismus. This is doubly unfortunate because not only is there a misdiagnosis, but also failure to treat. Of the many conditions responsible for sexual pain, vaginismus is the easiest to treat.
The word ODYNE means pain. Therefore vulvodynia is pain anywhere in the vulva. Vestibule means room and refers to the area just before entry into the vagina, inside the labia. This potential space (just prior to entry) is called the vestibule. Pain here is vestibulodynia, and the old term is vulvar vestibulitis syndrome, or vestibulitis for short.
When I test my patients with a cotton tipped applicator, “Q-tip test”, about 1/2 test positive for either or vulvodynia and/or vestibulodynia, These are mostly “false positive ” tests in that the woman does not have this condition, but rather it is a manifestation of fear and anxiety to penetration. It is “too close for comfort”. Many of my more severe vaginismus patients are unable to differentiate between pain and anxiety when tested and have a marked aversion to be touched in these areas.”

Another Forum member also writes:
“I’ve never considered myself to have vulvodynia or vestibulodynia, but I can see how this pain (which was purely down to anxiety) could be misinterpreted if a doctor did a gyn exam. While I was self-diagnosed, I did mention my vaginismus to a nurse once and she thought I was talking about vulvodynia or vestibulodynia (I can’t remember which) and seemed unaware of vaginismus. She suggested I see the nurse practitioner who could give me some numbing cream (I didn’t go to get this as I had a feeling it wouldn’t do much!). On another occasion I saw my doctor to ask if there was anything she could do or a specialist she could send me to regarding my vaginismus. I told her I was already working with dilators, although I had been working with them for about 4 years at the time and had not made sufficient progress . . . she said that as I was already doing that there was nothing else she could think of. It therefore took us (after a year or so of deliberating and saving) to take a trip over to the states from the UK to have a shot at proper treatment.”

In 2008, a couple of years after our 10/06 wedding and still unable to achieve intercourse, I went to see a gynecologist. When she attempted to examine me, I felt excruciating pain at even the outside area. She immediately stopped the exam, diagnosed me with vulvodynia, and said I would have to visit a physical therapist before she would ever try to examine me again. I had brought research about vaginismus to the appointment and showed it to her plus explained all of the symptoms that I had and she would not even read it and just dismissed it saying that I had vulvodynia. I did, in fact, have vaginismus and was one of these patients who couldn’t differentiate between pain and anxiety with testing and I was cured within 1 week of receiving the Botox treatment for vaginismus.