Conditions

Vulvodynia

Women with Vulvodynia have chronic vulvar pain with no known cause. Until recently, doctors didn’t recognize this as a real pain syndrome. Even today, many women do not receive a diagnosis. Women may go years being incorrectly diagnosed. They may also remain isolated by a condition that is not easy to discuss. Researchers are working hard to uncover the causes of Vulvodynia and to find better ways to treat it.

Types of Vulvodynia

Vulvodynia affects the vulva, the external female genital organs. This includes the labia, clitoris, and vaginal opening.
There are two main subtypes of vulvodynia:

• Generalized vulvodynia is pain in different areas of the vulva at different times. Vulvar pain may be constant or occur every once in a while. Touch or pressure may or may not prompt it. But this may make the pain worse.
• Vulvar vestibulitis syndrome is pain in the vestibule. This is the entrance to the vagina.  Often a burning sensation, this type of vulvar pain comes on only after touch or pressure, such as during intercourse.

Vaginismus

When a woman has vaginismus, the muscle walls of her vagina contract or spasm in response to attempted insertion, for example, with a tampon or Penis. This involuntary muscle contraction can be mildly uncomfortable or it may cause searing or tearing pain.

Vaginismus can interfere with normal activities like sex or having a pelvic exam at the doctor’s office.

Painful sex is often the first sign that a woman has vaginismus. The pain occurs only with penetration. It usually, but not always, goes away after withdrawal. Women have described the pain as feeling too small for a man’s penis. The pain has also been described as a tearing sensation or a feeling like the penis is “hitting a wall.”

Many women who have vaginismus also experience discomfort:

• when inserting tampons
• during a doctor’s internal exam

Dyspareunia

Dyspareunia is painful sexual intercourse due to medical or psychological causes. The pain can primarily be on the external surface of the genitalia or deeper in the pelvis upon deep pressure against the cervix. It can affect a small portion of the vulva or vagina or be felt all over the surface.

Vulvar Vestibulitis

Vulvar vestibulitis syndrome (also know as vestibulodynia or vestibular adenitis)  is a subset of vulvodynia that is characterized by severe pain during attempted vaginal entry (intercourse or tampons insertion), tenderness to pressure localized to the vulvar vestibule and redness of the vulvar vestibule.

Pelvic Radiation Therapy

If you receive radiation therapy to the pelvis, your doctor may recommend that you use a vaginal dilator to improve the elasticity of your vagina. This is important to make follow up examinations easier and more comfortable.

After radiation treatment to the pelvic area, scar tissue begins to form in the vagina and the tissue becomes less elastic and dry. There may be some shrinking of the vagina and vaginal opening. Scarring of the vaginal tissue result in adhesions, or areas where scar tissue forms, sealing the sides of the vaginal together. This can make it difficult for the doctor to perform vaginal exams and makes sexual intercourse difficult and uncomfortable. Your doctors, nurses, and physical therapist can answer any questions or concerns you may have. Don’t hesitate to ask them.

Menopause

During or after menopause, vaginal dryness and the thinning and weakening of vaginal walls can cause pain or stinging during penetration, especially if you’re not having regular sex or using vaginal moisturizers. The vagina narrows and shortens and the tissues become more fragile, vaginal dilators or vaginal trainers are part of the solution for many women who’ve reached this point. 

Pudendal Neuralgia

Pudendal neuralgia is pain related to the pudendal nerve, which is the main nerve running between your pubic bone and your tailbone. You might feel this type of pain as perineal (between your ‘sit bones’), or as deep pelvic pain.

Vaginal Stenosis

Vaginal stenosis is often a side effect of radiotherapy and/or genital surgery. It is the narrowing and/or loss of flexibility of the vagina, often accompanied by other changes such as the dryness and loss of resilience of scar tissue.

Vaginal Atrophy

Vaginal atrophy, also called atrophic vaginitis, is thinning, drying and inflammation of the vaginal walls due to your body having less estrogen. Vaginal atrophy occurs most often after menopause, but it can also develop during breast-feeding or at any other time your body’s estrogen production declines. For many women, vaginal atrophy makes intercourse painful — and if intercourse hurts, your interest in sex will naturally decrease.

Vaginal Agenesis 

The use of vaginal dilators or vaginal trainers should only be started after you have a complete exam, after your gynecologist makes the diagnosis of vaginal agenesis, and when you understand all of your options and have time to make a decision that’s right for you. Your gynecologist should review the following instructions with you. Monthly follow-up with your gynecologist is recommended while you are dilating.

Genophobia

Dilators after GRS (Vaginoplasty)

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