» Vulvar vestibulitis is an implication of dyspareunia in the form of severe, cutting or burning pain while pressing or irritating of area between virginal membrane and internal side of vulvar lips which is called a vulval vestibule. Vulvar vestibulitis occurs in around 12% of women proving that this is a rather frequent disorder.
Vulvar Vestibulitis Symptoms
At the moment of penetration, a patient suffers from local pain which reduces when penis stops moving and resumes when it starts frictions again. Medical experts are not sure on how it happens, but nerve tracts leading pain signals from vulva and brain parts processing these signals have modified physically and become more sensitive. As a result, a touch which is earlier was accepted as smooth, now is accepted as painful. Muscles in pelvic area may also become tense and enhance pain. After a sexual intercourse a woman may feel burning sensation in pelvic area or during urination.
Vulvar vestibulitis is considered to be a chronical pain syndrome. Thus, a pain doesn’t disappear (very often over a number of years) and is relieved with the help of treatment. It happens each time when the pressure is applied to the area around vaginal opening. Women suffering from this disorder often feel other types of chronic pain, such as jaw pain or irritable bowel syndrome pain.
A doctor may diagnose vulvar vestibulitis based on pain description, time and location of its occurrence. In order to confirm the diagnosis a cotton plug is used to check the painful areas. First, he applies a plug in areas which shouldn’t be sickly and then around the vaginal opening. If a pain occurs, the diagnosis is confirmed. During examination of women with this pathology a doctor may notice small red spots on the area of vaginal opening. Another symptom of vulvar vestibulitis is swollen mucosa, serosal or suppurative membrane, cup craterization on mucosa.
Vulvar Vestibulitis Causes
According to research studies vulvar vestibulitis takes place in the following cases:
- Sensitive nerves feeling pain increase anomalously resulting from various inflammatory reactions of mycotic infections. Activity of mastocytes enhances nerve growth factor and causes a ten-fold increase of pain in vaginal opening.
- This disorder may develop as a result of other diseases, such as atrophic vulvitis, vaginitis, bartholinitis, inflammatory process in urethra, coccal infection in vaginal opening as well as herpes simplex hepatitis.
- Genetic predisposition causing pain with the first sexual experience.
- Hormonal disorder manifesting itself as a result of long intake of contraceptive pills. Reduction of testosterone causes damage of epithelial layer of vaginal opening where a lot of androsterone receptors are located.
- Semen allergy.
- Dyspareunia may result from usage of antimycotic ointments or chemical substances contained for instance in remedies for intimate hygiene or sanitary pads.
Nevertheless, there are no reliable data proving which cases cause the development of vulvar vestibulitis. It should be noted that 90% of women suffering from this disorder have the accompanying pathology, vaginitis. It characterizes involuntary muscle contraction of vagina preventing from penetration of penis of any other object to vulva.
Vulvar Vestibulitis Treatment and Prevention
Intensity of pain may be different. For some women it is tolerable and they can have sex, others have such a strong pain that even a slight touch is sensitive. At a later stage vulvar vestibulitis results in fear of sexual contact and has to be treated not only by traditional means (medications) but also with the help of therapeutic counseling.
Because of impossibility to have a normal sexual life a women has inferiority complexes, she becomes irritate, gloomy and quick-tempered. Very often she suffers from a deep depression requiring a specialized therapeutic treatment. Since this disorder is considered to be a chronical pain syndrome, many kinds of treatment are applied. They include various methods of stress controlling, psychological methods allowing women to struggle thoughts and emotions accompanying pain and specific methods of pain treatment.
Diagnosis should be confirmed subject to a gynecological exam by a doctor. After diagnosis approval and its differentiation with other diseases of female sexual organs a doctor will assign methods of lab diagnostics, including analysis for AIDS and STD. Also, ultrasound investigation of pelvic organs is performed, microflora and cytology swabbing is taken.
Treatment of vulvar vestibulitis may be conservative and operative. Conservative therapy is pre-dominant.
It is based on such medications as:
- Anti-inflammatory drugs
- Hormonal drugs in the form of tablets and for local administration
- Antiepileptic agents
- Interferon injections
- Analgetic drugs
The main condition of successful therapy is a combination of medication treatment with physiotherapeutic procedures. As it was mentioned above, patients suffering from this pathology are recommended visiting a psychologist.
When a woman is ready to try a sexual intercourse, she may use anti-inflammatory or analgetic creams (for example, lidocaine). They are applied twice a day. A doctor should instruct a patient where these crèmes should be applied and where they are more effective. On the first stage a mirror may be very helpful. Anti-inflammatory or analgetic creams may cause blockage of changes in nerve tracts that increase susceptibleness to pain.
Patients should avoid irritants, such as soap, bath foam, daily pads, and tight jeans in order to prevent from symptoms aggravation. Women should make exercises for relaxation of pelvic muscles, and do yoga.
In case a woman with vulvar vestibulitis suffers from secondary occurrence of yeast fungus, she should be assigned a long-term treatment to prevent from infection development. One of such kinds of therapy implies introduction of capsules with boric acid in vagina once a week.
Surgery Might Be an Option
If after some period of time the effect of conservative therapy is not achieved, the operative treatment is indicative.
The main indications to its performance are:
- Occurrence of intolerable pain;
- Sensitivity disorder in the area of vaginal opening;
- Irritable bowel syndrome development;
- Interstitial cystitis.
» Surgery of vulvar vestibulitis is not complex and is performed under regional and general anesthesia (lasts no longer than one hour). A part of area around vaginal opening will be removed. In the course of this procedure all hypersensitive nerve endings are removed, but there are cases when nerves regenerate causing repetitive pain. After the operation a patient stays one day at hospital under the care of a physician. Restoration after surgery is very fast.
Canadian Pharmacy Experts – www.mycanadianpharmacypro.com