Vaginismus vs Vulvodynia

Women’s pelvic health conditions can be complex and confusing to diagnose. Distinguishing between vaginismus vs. vulvodynia and vestibulodynia can help you accurately diagnose and treat these conditions.

What Is Vulvodynia?

Vulvodynia is a painful, long-term condition that affects the vulva or the external female genitalia. It causes pain, discomfort, burning, stinging, or soreness in the area without any obvious physical cause. The pain may be continuous or intermittent and can worsen if you touch or put pressure on it [1].

What Is Vulvar Vestibulitis?

Vulvar vestibulitis or vestibulodynia is a painful condition that affects the vestibule, which is the area of the vulva around the vaginal opening. Vestibulodynia is a type of vulvodynia where the vulva’s vestibular area gets inflamed or swollen [2].

What Is Vaginismus?

Vaginismus occurs when the muscles around the vagina, or the female genital opening, involuntarily tighten or spasm when something penetrates it. This can make sexual intercourse, gynecological exams, or tampon use painful or difficult [3].

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Vaginismus vs. Vulvodynia

Vaginismus and vulvodynia both affect the female genital area and cause pain and discomfort, but they differ in their causes, symptoms, and treatment.

Causes

Vaginismus is often due to psychological factors like anxiety or trauma. This causes the muscles around the vaginal opening to tighten and hurt [3].

In contrast, the exact cause of vulvodynia is unclear, but it may involve factors like nerve irritation, inflammation, hormonal changes, or pelvic muscle issues [1]. When the pain is localized to the vestibule, it’s called vulvar vestibulitis or vestibulodynia. An overgrowth of nerve fibers in the vulva can also cause pain and sensitivity, leading to a subtype of vestibulodynia known as neuroproliferative vestibulodynia [2].

Symptoms

Here’s how to differentiate between vaginismus vs. vulvodynia symptoms.

If you have vaginismus, your vaginal muscles involuntarily tense or tighten during penetration, which can be painful, especially during sex or when inserting a tampon or gynecological probe [3].

Conversely, vulvodynia involves pain or discomfort in the vulva that may persist or come and go. In rare cases, if the pain is localized in the vestibule, you might also notice small skin-colored bumps known as vulvar vestibulitis bumps [1, 4].

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Treatment

Treatment for vaginismus may include topical pain relievers and counseling to address psychological factors like anxiety and trauma contributing to the condition. This can be combined with vaginismus physical therapy, including pelvic floor exercises for vaginismus, to help relax and control the muscles in the vaginal area [3].

If you have vaginismus, pregnancy can be physically and mentally challenging. Consult your doctor to manage vaginismus and pregnancy. They may also modify vaginismus exercises for pregnancy and provide guidance for safe and effective care [3, 5].

Vulvodynia and vulvar vestibulitis treatment includes medications and topical treatments to reduce pain and inflammation. Physical therapy can also help ease your pain. New treatments for vulvodynia include Botox and anti-inflammatory topical gels. Acupuncture is also an option, but you must choose an experienced practitioner [1, 2, 6, 7].

Additionally, dietary changes can help you manage vulvodynia symptoms. Foods to avoid with vulvodynia include spinach, beets, peanuts, and chocolate. They contain oxalates, which can increase inflammation and worsen your vulvodynia symptoms [6, 8].

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