Vulvadynia or vulvodynia is simply pain in the vulvar or vaginal area.

• Common patient complaints are:    a burning sensation in the vaginal region,  simple touch feeling like scraping or poking, an inability to wear tight or fitted slacks or to tolerate the feel of underwear, or an  inability to tolerate wearing tampons.  Sometime patients report an unrelenting intense itching sensation that does not have a dermatologic origin.

• The reason?  Well, that is not so well understood.  There are literally dozens of possible reasons.  In some cases, there is a link with autoimmunity or other inflammatory conditions in the body.  Sometimes there are abnormal c-fibers in the tissue, sometimes it is a pudendal nerve issue.  Often tight pelvic floor muscles are involved (either a precursor or a result of the pain).   The honest truth is that we often don’t know the exact cause, but we have treatments which often help. Part of the reason for our 2 hour initial visit is to assess several possible factors: entrapped genitofemoral or dorsal or perineal branches of the pudendal nerve, carefully assessing the integrity of the skin, evaluating the pelvic floor muscle and wall tension, assessing the deep fascia in the abdominopelvic cavity, and getting a clear treatment plan. The truth is that the pain is often multifactorial, and it takes a bit of detective work to assess the system as a whole.

• Vulvar vestibulitis is a specific form of vulvadynia, in which the tissues at the entry to the opening of the vaginal canal are hypersensitive.  Vulvar vestibulitis patients often have increased c-fibers or pain sensitive fibers in the tissues in this small area.  Sometimes the area just at the opening of the vagina is red and inflamed.

•  Please know  that whether you are vulvadynia or vestibulitis sufferer, you are not alone, and you are definitely NOT crazy.  Many therapies are available to help reduce or eliminate this pain.  Often many manual techniques internally and externally, including visceral mobilization, myofasical techniques and direct muscle release techniques (internal and external ) are helpful.  We may contact your referring physician regarding topical agents we may suggest as prescriptions to assist the treatment.  We may refer you to a vulvar pain specialist to help us.  Additionally, extensive lifestyle modification tips, from self care to diet to meditation or yoga technique may be utilized.