We understand that living with vulval and vaginal problems can feel isolating and challenging. These conditions can be difficult to live with, but together, we can try to make them more manageable. Many people with vaginismus and vulvodynia find treatment plans that work for them. We speak with Dr Simone Vella, consultant gynaecologist at Ross Hall Hospital, about vaginismus and how to treat it.
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So, what is vaginismus and what is vulvodynia?
Vaginismus happens when the muscles around the opening of your vagina spasm as something, such as a tampon or a menstrual cup, enters the vagina. It can make having sex painful, or sometimes even impossible. You have no control over the muscle spasm. Often, because vaginal penetration has been painful before or because you are afraid that it is going to be painful, the muscles around the vagina become more tense making the pain worse. This results in a burning pain during and sometimes after sex. We do not know what causes vaginismus.
On the other hand, vulvodynia is described as a burning pain on the vulva which can be generalised or localised. There is no obvious cause for the pain. Often it is localised to the area around the entrance of the vagina and this is called vestibulodynia. In this case, the pain is often provoked by touch, for example when having a smear test or when inserting a tampon. The pain can settle as soon as the stimulus is removed or alternatively last for days afterwards. With vestibulodynia or vulvodynia there is often nothing to see on the skin, or at most a slight redness around the entrance to the vagina.
Vaginismus and vulvodynia can lead to feelings of anxiety, shame, embarrassment, or frustration and this can negatively impact your overall wellbeing and everyday life as well as your relationships and your ability to have a fulfilling and satisfying sex life.
How are vaginismus and vulvodynia diagnosed?
There isn’t a diagnostic test for either condition. Vaginismus and or vulvodynia are typically diagnosed after an in-depth discussion about your symptoms with a gynaecologist who specialises in this area.
Your doctor will want to conduct a physical examination of your pelvic as well as your vulvovaginal area to look for any underlying physical conditions or infections that could be contributing to your symptoms. Remember that you should feel in control during examination. Your doctor will be very gentle. Sometimes, you may not feel able to have a vaginal examination during your first consultation. However, just examining the vulval skin and using a cotton swab to delineate the area of pain is very useful.
If you have vaginal problems and would like help, you can book an appointment with a consultant gynaecologist to begin your treatment journey. Leave a comment below if you’d like more expert videos from consultants about everything women’s health.
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Dr Simone Vella is a consultant gynaecologist at Ross Hall Hospital.
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