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VESTIBULITIS: Let's talk about it

There are many treatment options available for vestibulitis.
The symptoms of vestibulitis can leave women dealing with chronic pain and sexual difficulties.

What is vestibulitis?

Vestibulitis, also known as vulvar vestibulitis syndrome (VVS), is a condition that affects the vestibule, which is the area surrounding the entrance to the vagina. The exact prevalence of vulvar vestibulitis in the United States is not well established. It is estimated that vestibulitis affects approximately 10-15% of women who have chronic vulvar pain or genital discomfort. However, it's important to note that these estimates may vary depending on the population studied and the diagnostic criteria used.

Vestibulitis is considered a relatively common cause of chronic vulvar pain, but due to its underdiagnosis and the potential variability in reporting, the true number of women affected by VVS may be higher than currently estimated.

What are the symptoms of vestibulitis?

The symptoms of vulvar vestibulitis can vary from person to person, but typically include:

  • Pain: especially during sexual intercourse or physical examination.

  • Burning: experienced in the vestibular area.

  • Itching or irritation: located in the vestibular area.

  • Tenderness: the vestibular area may be tender to the touch.

  • Redness: the vestibular area may appear red and inflamed.

What are the causes of vestibulitis?

The exact cause of vestibulitis is not well understood, but there are several factors that may contribute to its development. These include:

  • Nerve hypersensitivity: Some researchers believe that vestibulitis may be associated with an increased sensitivity of the nerves in the vestibular area. This heightened sensitivity can lead to pain and discomfort.

  • Hormonal factors: Hormonal imbalances, such as low estrogen levels, have been suggested as potential factors in the development of vestibulitis. Estrogen helps maintain the health and function of the vulvar tissues, and a deficiency in estrogen may contribute to inflammation and pain.

  • Certain medications, including certain birth control pills.

  • Genetic factors: There may be a genetic predisposition to developing vestibulitis. Studies have shown that women with a family history of chronic pain conditions, including vestibultis, may have a higher risk of developing the condition themselves.

  • Inflammatory response: Inflammation in the vestibular area may play a role in vestibulitis. It is believed that chronic inflammation can lead to nerve sensitization and increased pain perception.

  • Infections or trauma: Previous infections, such as recurrent yeast infections or urinary tract infections, or traumatic events in the vulvar area, such as childbirth or surgery, have been suggested as potential triggers for vestibulitis in some cases.

What are the potential consequences of vestibulitis?

Vulvar vestibulitis can have several consequences that impact a person's physical and emotional well-being. Some of the potential consequences of vestibulitis include:

  • Chronic pain and discomfort: The primary consequence of vestibulits is persistent pain and discomfort in the vulvar vestibule. This can significantly affect a person's quality of life, making daily activities, including sitting, exercising, and sexual intercourse, painful and challenging.

  • Sexual difficulties: vestibulitis can interfere with sexual function and intimacy. Pain during sexual activity, known as dyspareunia, is a common symptom of vestibulitis and can lead to affecting our libidos by reduced sexual desire, avoidance of sexual activity, and relationship strain.

  • Emotional distress: Living with chronic pain and discomfort can take a toll on a person's emotional well-being. Vestibulitis can cause feelings of frustration, sadness, anxiety, and depression, particularly when the condition is not well understood or properly diagnosed.

  • Impact on relationships: The pain and sexual difficulties associated with VVS can strain intimate relationships. Communication and emotional support from partners are crucial to navigating these challenges.

  • Lifestyle limitations: Due to the pain and discomfort, individuals with VVS may need to make adjustments to their lifestyle. This can include avoiding certain activities, using specialized cushions or sitting positions, and limiting physical exertion.

How can vestibulitis be treated?

The integrative medicine approach to treating vulvar vestibulitis syndrome (VVS) involves combining conventional medical treatments with complementary and alternative therapies. The goal is to provide a personalized treatment plan that addresses the physical, emotional, and lifestyle factors that may be contributing to the condition. Some of the complementary and alternative therapies that may be used in the treatment of vestibulitis include:

  • Identifying and removing the cause- if possible

  • Vaginal moisturizers

  • Vaginal hormones

  • Acupuncture

  • Herbal remedies

  • Mind-body therapies

  • Diet and nutrition

  • Vaginal physical therapy

The bottom line:

You do not have to live with symptoms of chronic vaginal pain or painful intercourse. If you suspect you may have VVS or are experiencing symptoms of chronic vulvar pain, it is recommended to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.

Carol Rademeyer is a highly regarded Advanced Practice Registered Nurse with a wealth of experience in women's health. With over 25 years of professional practice and a Master of Science Degree in Midwifery from the Midwifery Institute at Philadelphia University, she is a respected expert in her field. Her rigorous academic and professional background has earned her board certification in her specialty, and she has fulfilled the requirements in Florida for Autonomous Practice as an Advanced Practice Registered Nurse.

In addition to her clinical practice, Carol has also made significant contributions to the broader medical community. She has been published in several prestigious medical journals and has been a speaker at the national conference for the American College of Nurse Midwives, where she has shared her expertise and insights with her peers.

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