Anyone who has experienced vulvar pain knows it can be an uncomfortable, distressing feeling. And although it might seem like you’re the only one experiencing such pain, vulvar pain is common and often very much treatable.
This week, we will look at the most common vulvar pain causes and symptoms we see and treat. In many cases, we have found that pelvic floor physical therapy can effectively ease or eliminate the painful symptoms associated with vulvar pain.
What Is Vulvar Pain?
The vulva refers explicitly to the external tissue that surrounds the opening of the vagina (i.e., the clitoris, labia, and vaginal/ urethral opening). Vulvar pain can occur in one or more of these areas and may also cause pain inside of the vaginal canal. For some individuals, this pain may radiate (or travel) through the pelvic cavity. These symptoms may be constant or come and go with things like physical contact or pressure to the vulva. They may even occur spontaneously.
It is worth noting that this pain is neither contagious nor sexually transmittable.
Vulvar Pain Symptoms
The most common symptoms reported by individuals experiencing vulvar pain include burning, itching, stinging, or throbbing sensations. Many individuals report a feeling of rawness in the area. Sometimes the tissue will appear red, irritated, or dry, but this is often not the case; the tissue will often look healthy and “normal”.
While these painful symptoms generally result from specific conditions, external factors may play a role as well. Certain activities such as sex, inserting a tampon, or wearing tight-fitting clothes can irritate vulvar conditions and exacerbate symptoms. For this reason, vulvar pain during one’s period is a symptom many of our patients experience.
- RELATED: Pelvic Pain During Sex Explained
Vulvar Pain Causes & Conditions
Like so many conditions and concerns relating to sexual health, the exact causes of vulvar pain are not well understood. Though many conditions can be linked to these symptoms, figuring out the exact cause (and treatment) may require a bit of time and patience.
Two vulvar conditions that we regularly see and treat include vulvodynia and vestibulodynia.
Vulvodynia
Vulvodynia is diagnosed when an individual experiences chronic vulvar pain symptoms that last for longer than three months. The exact cause of vulvodynia is not known and symptoms can vary. The pain associated with vulvodynia is typically caused by hyper-sensitive nerve endings in the vulvar area. Trauma to the vulvar area, inflammation, and genetics are all considered possible factors in the development of vulvodynia.
One of the most common misconceptions about vulvodynia is that it results from poor hygiene or the use of certain products. Although this is not at all true, maintaining good vulvar hygiene is important! We will dive deeper into that in a future post, so stay tuned!
Vestibulodynia
Vestibulodynia refers to pain that occurs at the opening (or vestibule) of the vagina. It is, essentially, a more localized and specific form of vulvodynia. As with vulvodynia, the exact cause of vestibulodynia is not well understood. Nerve damage and sensitivity are thought to be primary contributing factors here as well.
Vulvar Pain Treatment Options
If you have been experiencing vulvar pain, you should talk to a doctor or pelvic specialist about your symptoms. Open and honest communication is the best course for diagnosing and treating your symptoms. Although it can be difficult to talk about, providers are used to discussing these types of concerns and are here to help you feel better.
Treatment options for vulvar pain include pain-relieving and anti-inflammatory creams, biofeedback therapy, and cognitive behavioral therapy to help address the psychological effects of the chronic pain.
Pelvic floor therapy is also proven to be effective at helping to reduce or eliminate some of a patient’s painful symptoms.
Pelvic Floor Physical Therapy
Pelvic floor physical therapy is regularly used to treat all kinds of abdominopelvic conditions. Many conditions that affect this area of the body, such as vulvar pain, result in pelvic floor muscle tension.
As it relates to the vulva, the role of the pelvic floor muscles is to support the external genitals and their functions. When there is too much tension, these muscles can compress the nerves that travel to the vulva and cause pain. Tension in these muscles can also change how our pelvic moves and contribute to increased irritation of the vulvar tissue if it experiences too much friction from the clothes we wear. For many individuals, pelvic floor muscle tension and pain play off of one another, making reduction of tension extremely beneficial in reducing pain and vice versa.
Manual interventions can be highly effective at reducing both muscle tension and pain. These can include internal manual techniques applied directly to the pelvic floor muscles or external techniques to improve tissue and joint mobility. Strengthening of the muscles that work with the pelvic floor can also be helpful to ensure that the body is balanced and that the pelvic floor muscles are not working too hard (this can encourage them to hold onto tension).
For some individuals, biofeedback can be used to help the muscles lengthen and reduce tension. Biofeedback gives us a visual representation of what the pelvic floor muscles are doing; this can be useful when learning to intentionally relax these muscles.
Like any other form of pain, pelvic floor therapists can help individuals learn
How Grace Physical Therapy Can Help
Although vulvar pain can be complicated, our team at Grace Physical Therapy & Pelvic Health is always here to listen and help! We know trying to diagnose the source of your pain can be confusing and even embarrassing at times. That’s why we are committed to working with you to understand your condition and help you along the path to recovery.
If you have been experiencing vulvar pain that won’t go away, schedule a consultation today. We have in-person appointment options available at our three locations Raleigh, Durham, and Chapel Hill. We have telehealth consultation options available as well!
Until Next Time,
The Grace PT Team
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