Vulvar pain – what is this?

Vulvar pain is a “complex pain syndrome with unknown etiology, characterized by constant of intermittent generalized vulvar pain or localized burning sensations in the vestibule area when pressure is applied (vestibulodynia, or vulvar vestibulitis syndrome). Typically, vulvar tissue with vulvodynia appears normal without infection or skin disease. Vulvodynia impacts negatively on a woman’s quality of life as it interferes with sexual and daily activities.” 2018 ICD-10-CM Diagnosis Code N94.81: Vulvodynia

But what does this mean? It means that you have pain in your vulva – maybe in your labial tissues, your clitoral area, your vagina either at the opening or vestibule, or deep inside. It can occur for a variety of reasons, that may have to do with physical or emotional trauma, or infection in the area (a bladder infection or yeast infection can be a common precursor) or may have no discernible reason for beginning at all. It can limit a woman’s ability to sit, walk, wear tight clothes or clothes with seams that press on her vulva, or pubic bone or tailbone or inner thighs. It can prevent her from enjoying her children, her exercise or her work and home life. It can stop her from having the sex she wants to have. It can be a tough diagnosis as it is invisible, meaning no-one knows you have it just by looking at you.

I have worked with vulvar pain conditions for 15 years, helping women to reclaim their physical and sexual identities by addressing the reason for pelvic pain through thorough investigation of their unique experience (see About) and provision of specific home strategies for addressing their barriers to a healthy pain-free vulva.  Treatment includes education, specific release of tight, restrictive tissues and training of muscles that are not doing their jobs well. It can involve vaginal dilators to help train your body to have things inserted into your vagina. Once inside that dilator becomes a foam-roller for your pelvic floor, a powerful tool for release and training the muscles and connective tissues to be able to do their jobs well and relieve the pain. I teach and train you and your partner to use these tools, increasing your ability to manage independently. I give parameters to allow a safe, comfortable, independent, progressive treatment plan.  Treatment goals are identified by you, allowing both parties to understand what we are aiming for, and when we have achieved our objective.

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