Vulvar vestibulitis syndrome, also called VVS, is pain around the vulva that originates from the vestibule, hence the name. Women’s experiences with this chronic condition can be different. While some have primary vulvar vestibulitis syndrome that begins the first time they attempt to use a tampon or have a vaginal exam, others have secondary vestibulitis that comes out of the blue after several years of having no issues with tampon use, vaginal exams, or being sexually active. Vulvar vestibulitis symptoms can take a toll on everyday life and sexual health. While going about your day, pain levels can range from distracting to unbearable. The pain can even be enough to cause some women to avoid sex. It’s important to know about vulvar vestibulitis symptoms and treatment if you’re experiencing undiagnosed vaginal pain.
Vulvar Vestibulitis Symptoms
Pain is the primary vulvar vestibulitis symptom. Pain generally radiates in the vulva and opening of the vagina. However, pain location and intensity aren’t necessarily universal for all women with VSS. Pain can either be broad or localized. Certain activities may also trigger more pain and discomfort than others. Here’s a look at vulvar vestibulitis symptoms:
- Burning, stinging, and irritation
- Rawness or soreness
- Strong, sharp knife-life pain
- Aching and throbbing pain
- Swelling
- Pain triggered by biking or sitting for long periods of time
- Pain from tight clothing
- Pain from workouts or physical activity
- Pain when trying to use a tampon
- Pain during sex
- A sensation that you need to pee suddenly
- Unusual vaginal discharge
- Red blotches around the opening of the vagina
Vulvar vestibulitis symptoms are constant for some women. They may experience pain and swelling to some degree around the clock. For others, symptoms may only flare up when the vulva is irritated by touch, rigorous activity, or wearing ill-fitting clothing.
Causes of Vulvar Vestibulitis
Causes of vulvar vestibulitis aren’t fully known. However, there are several factors that are believed to play roles in VVS. For example, one school of thought is that some women simply have more nerves in the vulva area. This results in heightened sensitivity caused by nerves that send pleasure and pain signals through the nervous system to the brain.
Women may be at higher risk for developing VVS if they have a history of infections in the vagina. Past injury and irritation involving the nerves of the vulva can also increase risks. A sudden onset of VVS could potentially be an allergic reaction to fabrics or detergents. Finally, VVS could be caused by weakened pelvic floor muscles caused by childbirth, surgery, or physical injury.
Vulvar Vestibulitis Misdiagnosed as Vaginismus or Vulvodynia
VVS is sometimes misdiagnosed as a condition called vaginismus that’s characterized by involuntary muscle spasms that interfere with vaginal intercourse or penetration. While vaginal pain is a shared symptom of both, the pain experienced with vaginismus is caused by the tightening of pelvic floor muscles. Meanwhile, VVS specifically involves provoked or unprovoked pain of the vulva. Vulvar vestibulitis and vulvodynia are quite similar. VVS is technically a subset of vulvodynia. However, vulvodynia is a much broader diagnosis that refers to pain that can be experienced in the clitoris, labia majora, labia minora, urethra opening, vestibular bulbs and vestibule, urethra opening, vaginal opening, Bartholin’s gland, and more.
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Treatment for Vulvar Vestibulitis
Due to the fact that VVS can have different underlying causes and triggers, treatment for vulvar vestibulitis is handled on a patient-by-patient basis. Once your care provider has established a VSS diagnosis, they may work with you to identify potential causes of vulvar vestibulitis that apply for you. Potential vulvar vestibulitis treatment options can include:
- Medications that treat inflammation and atrophy
- Switching to hypoallergenic detergents and soaps
- Avoiding some fabrics
- Avoiding tight-fitting pants and shorts
- Pelvic floor exercises or physical therapy
- Diet modification to reduce inflammation
- Injection therapies
- Laser therapies
- Surgery
Finally, it’s important to know that itching is not a sign of VVS. If you’re experiencing itching that’s accompanied by pain and other VVS symptoms, it’s so important to rule out infection or illness with the help of a care provider.
If you’re interested in learning more about treatment for vulvar vestibulitis, Dr. Michael Tahery is here to help you understand this diagnosis better. Dr. Tahery is an Obstetrician-Gynecologist (OB-GYN) and Urogynecologist in Los Angeles and Glendale, CA with more than 25 years of experience. Dr. Tahery and his staff are leaders in gynecology, urogynecology, and cosmetic care here in the Los Angeles area. Book an appointment today!