Do I have Vaginismus or Vulvodynia?

[Macgomes]

Hello everyone,,
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.”

[recessivegenequeen]

Hi Macgomes – Dr. Pacik’s post is accurate! At least in my understanding (I’ll let one of the doctors correct me), vulvodynia is more generalized pain around the vulva (which can have a range of causes) and vaginismus is pain upon attempted penetration as a result of muscle spasming that keeps the entrance tight (that’s a quick generalization, but you get the idea). If you’re not sure which you suffer from, you should see a gynecologist or sexual pain specialist and see what they say!

[Macgomes]

Hello everyone,,
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. https://xvideos.onl/ This is doubly unfortunate because not only is there a misdiagnosis, but also failure to treat. Of the many conditions responsible for sexual pain, https://xnxx.onl/ 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 https://chaturbate.onl/ 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.”
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Thank you my issue has been solved…..

[Petlovergirll]

Hello,

Gosh, I’m still confused here. My issue is I have extreme pain, like I’m being sliced with a knife, at the very entrance. I’ve tried using a sex toy which is wide with a “head”, then narrows, then widens, and so forth. I only hurt at the wide parts. No pain when it gets to a narrow part. But my husband is wider than the wide parts, so it hurts constantly until he exits completely. No amount of lube helps.

I’ve always thought that meant vestibulitis, because it hurts in the opening around my vagina, the vestibule. That the muscles of the pelvic floor remain in a chronic high tension state. This seems to describe my issue exactly. I thought vaginismus was a spontaneous tightening of the muscles of the vaginal wall. It doesn’t hurt me up inside my vagina. Only at the very outside opening.

Can anyone offer any advice or clarification?

Thanks so much!!

[Petlovergirll]

I should add that I used to be able to get aroused and have pleasurable sex for many years. I believe it was a med I used to take that lessened my arousal, and the slicing entrance pain started. I’ve had this pain both before and after menopause. I had an easy menoupause, no side effects.

Thanks!

[Jackie Giannelli, FNP-BC]

Hi Petlovergirll – you are right, this can be a confusing situation! But given that you’ve told me you have been through menopause, it’s likely that this pain is related to vestibulodynia (you are correct!). After menopause, the tissues in the transition zone between the vulva and vagina (vestibule) can atrophy due to lack of estrogen. This means they become thinner, dryer, more prone to micro-tears with intercourse, burning, irritation and even infection. As a result, the muscles behind the opening (pelvic floor muscles) can tighten and spasm in an unconscious attempt to guard against penetration. This is the “vaginismus” component, and it’s usually secondary to the menopausal changes. Of course it’s impossible to know this for sure without seeing you in person. But a good GYN or women’s health provider should be able to diagnose and treat you – there is NO reason you should be suffering with this kind of pain. Hope this helps:)
Jackie

[Petlovergirll]

Hi Jackie, thanks so much for your response! I do have an appointment with a local doctor to see what I can find out, but not for a few months. I’m trying to find out as much as I can before I go so I can ask really good questions in the time I have with the doctor.

You mentioned post-menopause atrophy due to lack of estrogen. One thing I didn’t mention is 4 of 4 gyneclogists prescribed estrogen cream to insert 3 times a week for painful sex. I’ve done this over 6 years and it never changed anything for me. Does it tell me something that the cream didn’t help?

Also, I had this same problem 5 or 6 years before menopause. Not sure what that all means, but just wanted to mention it.

Thanks again!

[mazemelissa]

Did you ever try to massage the estrogen cream directly into the vaginal entrance every day? Sometimes I feel that women use the applicator and insert the cream deep in the vagina, but the main issue is right at the entrance.

We also often use a combination of both estrogen and testosterone in a cream massaged into the vaginal entrance, daily or even twice daily if traditional estrogen cream is not helpful.

I also encourage active dilation with the application of the estrogen cream every night. It seems that you don’t have pain when something is small, but when the area is stretched wide, the pain occurs. So slowly stretching the tissue with with topical hormonal cream can be really helpful.

I would invest in some dilators and start increasing the sizes slowly. You will need to continue to dilate until you can insert something that is larger than your husbands penis, otherwise he will always cause pain.