What is vulvar vestibulitis?

Vestibulitis is a long term condition that brings pain to and around the vaginal opening when something is penetrating the vagina or is pushing against the opening.

Why do you get vulvar vestibulitis?

The pain is caused by overly sensitive nerve fibres reacting more strongly to external tensions. Some only experience pain connected to sexual intercourse and others can experience intense pain from light touches.

Vulvar vestibulitis is so far a relatively unknown diagnosis, both amongst women in general and within research. It has been recognised more over the past few years in connection to other women’s diseases such as endometriosis.

How do you recognise vulvar vestibulitis?

The most prominent symptom of vulvar vestibulitis is pain in the lower abdomen. The pain can be described as a burning sensation, caused even by a light touch. The pain can last for a few days in the worst cases after it has been triggered. Some redness around the opening of the vagina is also a common symptom. Due to the physical discomforts vulvar vestibulitis can bring it is not uncommon to experience anxiety and to be feeling down. Your confidence can be knocked, and it is common to blame one self for the vulval vestibulitis affecting your sexlife.

If you are have vulvar vestibulitis you will most likely experience several of the following symptoms:

  • A burning, intense pain in the vaginal opening during sexual intercourse where the pain can be triggered even by a light touch
  • In bad cases, the pain can last for several days
  • You experience pain from inserting a tampon or a finger into the vagina
  • You experience pain from activities such as horse riding, cycling or similar
  • Redness around the area of the vaginal opening

Causes for vulvar vestibulitis

It is currently not entirely clear why some women are affected by vulvar vestibulitis but there are certain factors which we know can cause vaginal dryness and thereby also overly sensitive nerve fibres:

  • Vaginal intercourse during lack of moisture
  • Sexual abuse
  • Vaginal infections
  • Different types of birth control containing hormones (some birth control pills contain a corpus luteum hormone which can cause vaginal dryness)

Large number of unknown cases

The number of women diagnosed with vulvar vestibulitis has increased over the past few years and it is expected that the number of unknown cases is quite large. The reason behind the increase could be explained by more people seeking treatment or getting diagnosed. In Sweden, it is not known exactly how many women are suffering by vulvar vestibulitis due to the criteria for the diagnose differing between regions.

Between 2001-2016 the number of girls/women treated for vulvar vestibulitis in Sweden was close to 9000, according to a study carried out by Socialstyrelsen 2018. About 54 000 women were treated in total if including other relevant diagnoses such as vaginismus and pain during intercourse.

Read more about the study here (in Swedish)

Seek treatment if you suspect you might have vulvar vestibulitis

You should always visit a doctor if you experience vaginal pain. To be able to diagnose vulvar vestibulitis it is needed to go through a gynaecological examination and to explain symptoms, what triggers the pain and how it is perceived. The sooner you get treatment the bigger the chance is to be able to go back to normal.

There are currently no medicine curing vulvar vestibulitis but the pain can be relieved by combining different treatments. We have gathered a few tips below on what you can do yourself to relieve discomfort:

  • Avoid washing your intimate area with soap
  • Add extra moisture
  • Use sanitary towels instead of tampons
  • Avoid penetrative sex when experiencing pain
  • Use lubrication during sexual intercourse
  • Avoid stressful situations when possible as this could increase pain and cause tension in the muscles
  • Try squeezing exercises
  • Try variations of relaxation exercises, yoga and mindfulness can according to studies have a positive impact

What happens during an examination

The doctor will examine the area around the vaginal opening during an examination of vulvar vestibulitis, to see if there is any redness. They will also try to find out where the pain comes from by gently pushing on different parts of the membrane with a cotton swab. Let the doctor know if it is hurting and ask them to stop the examination. The doctor will collect some secretion from the vagina which will be examined in a microscope. They usually also test for yeast infection and bacteria as well.

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