VVS, or vulvar vestibulitis, is a type of vulvar pain (also known in medical circles as vulvodynia). The vulva is the genital organ outside the female body, and the pain is concentrated in the vestibule, or the part of the vulva right around the vaginal opening. 

Generally, VVS causes skin irritation and redness and may also lead to discomfort and pain in the glands inside the skin. Doctors may also call the condition localized provoked vulvodynia or vestibulodynia to differentiate it from other types of vulvodynia. 

In this article, Dr. Andrew Krinsky and his expert team will discuss the main characteristics of VVS, talk about vulvodynia in general, and also give advice on possible treatment options for the condition. 

About Vulvodynia

Doctor and Patient Discussing Something While Sitting at the Table

To better understand vulvar vestibulitis, it only makes sense to talk a bit about vulvodynia in general. The condition refers to chronic pain in the vagina, genitals, and vulva with no explainable, apparent cause. 

Typically, vaginal and vulvar pain are pretty common symptoms in several conditions, like different skin disorders or infections. In this regard, vulvodynia is different. In these cases, the vulvar pain may last more than three months, not as a symptom of any peculiar condition. To make matters worse, the pain may even be so draining that it can keep women from doing everyday activities or things they enjoy. 

On another note, vulvodynia is the most common culprit behind dyspareunia or painful intercourse next to chronic pelvic pain in women in their reproductive years, i.e., have regular periods. Even with this information in mind, it’s difficult to pinpoint precisely just how widespread the condition is. Many women with vulvar pain won’t seek medical help as they may feel embarrassed because of the condition. On a more scientific note, diagnosing vulvodynia can often be challenging because researchers still struggle to answer what exactly causes the condition, leading to misdiagnosed patients. 

Even though researchers aren’t sure about the exact causes of vulvodynia, they have noted that the following issues may be potential contributors to its development:

  • Hormonal disorders
  • Inflammation
  • Neuropathic problems or nerve injuries
  • Inherited (genetic) factors
  • Past vaginal infections with long-term reactions
  • Pelvic muscle spasms or weak pelvic floor muscles
  • Skin irritation from harsh products 

On the other hand, people who are diagnosed with vulvar pain are diagnosed with other pain-related syndromes, such as:

  • Painful bladder syndrome
  • Temporomandibular disorder
  • Irritable bowel syndrome
  • Fibromyalgia

Stress and Vulvodynia

Some scientific data suggests that women with the condition are also more likely to be generally more stressed, with a history of abuse, and may be more likely to have specific behavioral conditions such as:

  • Depression
  • Anxiety
  • PTSD or post-traumatic stress disorder 

Still, it’s unclear whether there’s a direct link between these conditions and vulvar pain. As of now, data seems to suggest that behavioral health conditions can increase the chances of developing vulvar pain, but actually, patients may also develop depression and anxiety because of vulvodynia and the negative impact it may have on their lives. 

Back to VVS: Types of Vulvar Vestibulitis

Now that we’ve discussed the essentials regarding vulvodynia, we can get back to VVS. Typically, there are two main types of this condition, primary and secondary.

Primary VVS may present itself as pain when women first use tampons, become sexually active, or have a vaginal exam with a speculum. Secondary vulvar vestibulitis refers to vulvar pain that develops a while after the patient has had painless sex. 

Primary Symptoms of VVS

The signs of the condition may be a bit different for every patient. Some women may only experience mild symptoms, while others may be so uncomfortable that it disrupts their life. Also, symptoms may either come and go or be constant.

For the most part, the symptoms of vulvar vestibulitis may include the following: 

  • Pain resulting from pressure like touch, tight clothes, sitting, working out, or riding a bike
  • Burning sensation
  • Stinging sensation
  • Feeling raw
  • Frequent and sudden urges to urinate
  • Irritating and unusual vaginal discharge
  • Tiny red spots on and around the vestibular glands (they are right inside the vaginal opening)

Needless to say, VVS can take a massive toll on one’s sex life and intimate relationships. During sexual intercourse, the pelvic muscles may also tense up. This can lead to even more discomfort, leaving the patient with decreased sex drive and avoiding sex as much as possible. 

Possible Causes of VVS and Risk Factors

Unfortunately, any woman may develop the condition regardless of age and whether they’ve had sex or not; according to experts, the chances of developing vulvar vestibulitis may be higher if you:

  • Have a yeast or bacterial infection
  • Have HPV (human papillomavirus)
  • Have a sensitivity to cosmetic products like douches or soaps
  • Have endometriosis, or painful bladder syndrome (interstitial cystitis)
  • Have problems with the muscles supporting your vagina, rectum, bladder, or uterus
  • Use harsh soaps or detergents
  • Use specific lubricants and spermicides
  • Underwent menopause
  • Are going through a lot of stress

Diagnosing VVS

If your healthcare provider suspects you have vestibulodynia, they will first look for any physical symptoms like redness in the vulvar area. Also, they may use a cotton swab to check for the areas that cause pain. You may also be asked a series of questions regarding your family medical history. Lastly, the doctor might also recommend undergoing a series of tests to rule out any other conditions and infections. 

Treatment for Vestibulodynia

Woman in Doctor’s Office Frowning

Once you’ve received a definite diagnosis, there are actually several treatment options and a lot you can do to manage the discomfort. For instance, you can: 

  • Switch detergents
  • Consider using a mild soap
  • Avoid scented tampons or pads
  • Avoid wearing tight clothes 
  • Opt for breathable, cotton clothes
  • Avoid the activities that irritate the vulva (like bike riding)
  • Limit the consumption of alcohol, artificial sweeteners, and caffeine
  • Use cold compresses
  • Pour some lukewarm water over the painful area after urinating
  • Avoid hot baths and hot tubs
  • Consider using petroleum jelly or vegetable oil for skin-moistening purposes

If the pain doesn’t become more manageable after these home remedies, your healthcare provider may also help with several other treatment options, such as:

  • Pain medication
  • Medication in case of chronic itching
  • Nerve blockers in case of severe pain
  • Biofeedback therapy
  • Consulting for your sex partner and you
  • Physical therapy
  • Vaginal tightening to ease the symptoms and rejuvenate the vagina

Consider the MonaLisa Touch Laser Treatment

Laser therapy or vaginal rejuvenation may be a convenient and painless treatment method to find relief from the discomfort of VVS. The treatment delivers laser energy that affects the vaginal tissues, stimulating collagen production, which improves overall vaginal functionality, restoring trophic balance and triggering a healing response. It’s a safe and effective way for most women to return to their everyday activities and sex life.

If you are interested in the MonaLisa therapy in Tamarac, feel free to reach out to our professional and compassionate staff to schedule an appointment and learn more.