Vestibulodynia?

[newsoul11]

Hello!
I’ve introduced myself in the “New Members” thread but was wondering if I could hear from anyone who is diagnosed with vestibulodynia…

This diagnosis seems to most closely fit my current symptoms – my husband I called the pain in my vestibule “the ring of fire” (like the Johnny Cash song, lol) before I figured out that part of my body had a name! The pain in this particular area makes pelvic exams and pap smears difficult if not impossible, as well as sex or any other type of penetration. Even when I use the very small dilator with lubrication, I feel some pain in this particular area, but not deeper in my vagina. When I have tried to have intercourse recently, I feel the most pain in this area but also feel pain coming from what seems like tightness in my vagina. I’m not sure how to get a proper diagnosis for this issue, especially since any sort of pelvic exam is pure torture and usually ends with me sobbing.

I learned a great deal from some of the articles on the blog about vestibulodynia but I’m unsure of what to do next besides continuing with my dilators. I received a referral for pelvic floor physical therapy but I’m feeling sort of terrified about this and also having some difficulty finding a pelvic floor PT who takes my insurance. Would a pelvic floor PT be able to make this type of diagnosis (vestibulodynia and which specific subtype)?

I live in the Boston, MA area and would love if anyone had recommendations for providers in this area specifically!

[mazemelissa]

Hi NewSoul,

Thank you for bringing up this important topic. Vestibulodynia and Vaginismus can often have similar sx.

Here is info I took of the International Society for Sexual Medicine Website about Vestibulodynia:

Vestibulodynia refers to pain in the entrance of the vagina, known as the vestibule. This is the area where the outside portion of a woman’s genitals (the vulva) meets the internal portion (the vagina). The vestibule contains glands that provide vaginal lubrication during sexual arousal.
For a woman with generalized vestibulodynia, the pain is constant.
A woman with provoked vestibulodynia (PVD) has pain when the area is touched. This may occur when she inserts a tampon, has a pelvic exam with her gynecologist, or engages in sexual activity.
Pain intensity and type can vary from woman to woman. The area may be sore or tender when touched. There might be a sharp or burning pain. Some women are able to have intercourse. For others, the pain is too severe.
PVD can cause a great deal of distress. Women may feel anxious and depressed and lose interest in sex. Their relationships may suffer as a result.
Many issues may cause PVD, including hormonal changes, infections, and tight pelvic floor muscles. Some women have more nerve endings in their vestibule, making the area hypersensitive to touch. Stress responses and genetics may also play a role.
PVD is diagnosed with a “Q-tip test.” A doctor assesses pain by touching the vestibule with a cotton swab. He or she may also conduct a visual exam, analyze a vaginal discharge sample, or test the pelvic floor muscles.
PVD cannot be transmitted to a partner and cannot spread to other parts of the body.
Treatment for PVD varies depending on the cause.

Because vestibulodynia can be caused by high pelvic floor muscles, diagnosis and treatment with a physcial therapist is a good place to start.

Women with vaginimsus also have tight and uncontrolled high pelvic floor muscles, but they usually also have an accompanied fear and anxiety about penetration.

I think it is a great idea to see the Physical Therapist and get an evaluation. If your pelvic floor is still tight, then more work on the muscles should help resolve your pain.

If you don’t have pelvic floor dysfunction, then you might have one of the other subtypes of vestibulodynia, and would need alternative treatments.

Hope this helps.

Melissa

[Rachel Hercman, LCSW]

Hi newsoul,
great to hear from you!

[Heather34]

Hi newsoul. I wrote to you in the Vag General “Welcome New Members” thread and I wanted to reply to you here. I am so sorry for what you are going through. I, too, live in the Boston area and would love to email and talk further if you ever wanted to. If you have a chance, I would work with Maze in whatever way is possible as they understand so much about these conditions and know what treatments work and what treatments do not. In addition, I went to a really, really good Gynecologist in Brookline for my first time exam following my Botox procedure. Let me know if you want to know and I can share her name. Sending you support today.