What to know about vulvodynia and vaginismus


These little-known conditions are taking their toll on the lives of women of all ages, most of whom have never heard of vulvodynia or vaginismus until they finally get help.

As an OB/GYN specializing in the treatment of these challenging disorders, Dr. Allison Conn knows all too well the suffering they can cause.

“I see a lot of women who have lived in pain for a long time,” says Dr. Conn.

What is vulvodynia?

Women with vulvodynia have chronic pain, burning, itching or discomfort of the vulva, with no recognized cause. The vulva is the external part of the female genitals, including the labia, the clitoris and the opening of the vagina.

Usually the pain occurs with contact, like with intercourse or inserting a tampon, but it sometimes can occur spontaneously. Exercise or even sitting for long periods of time can make it worse.

Many women suffer for years from vulvodynia before seeking help. Others have seen multiple practitioners before they get to a vulvovaginal specialist like Dr. Conn. Misdiagnosis is common.

“Because vulvodynia can manifest as burning and itching, the women who come to me often have been treated over and over for recurrent yeast infections,” she says. “But they still have constant pain and itching.”

A poke or a pain?

Patient history is key to diagnosing this challenging condition, and so is the exam that Dr. Conn performs. “I use a Q-tip to touch different areas of the opening of the vagina, known as the vestibule, while asking the patient ‘Is this a poke or is this a pain?’ If it elicits pain, we can target treatments to that specific location,” she explains. “Patients will tell me no one’s ever been able to isolate their exact pain before.”  

Treatment options for vulvodynia include pelvic floor physical therapy, topical treatments and oral medications. But there’s no quick fix, cautions Dr. Conn. “I tell all of my patients they need to give treatment at least a good three months.”

For patients with vulvodynia, surgery may be considered as a last resort if conservative methods fail to provide relief.

In some cases, women with vulvodynia also suffer from vaginismus, although the conditions can occur independently.

What is vaginismus?

Vaginismus is an involuntary contraction or tightening of the muscles around the vagina. The condition can cause pain during intercourse. If the muscles tighten too much, penetration is difficult or even impossible. The condition can also include severe anxiety and fear of vaginal penetration due to pain.

Inserting a tampon or undergoing a pelvic exam may be too painful or uncomfortable for women who suffer from this condition. Diagnosis includes a complete physical exam to rule out structural abnormalities or other skin conditions.

Treatment mainstays include pelvic floor physical therapy to help with relaxation of the pelvic floor and often includes the use of vaginal dilators to work up gradually to sexual penetration. In some cases, women may need medications to help the pelvic floor relax enough so they can even take part in physical therapy.

Stop Living in Pain

To stop the suffering, start by visiting an OB/GYN specialist who is experienced in treating vulvovaginal and pelvic health conditions. With an accurate diagnosis and targeted treatment, relief is possible.

Could your pelvic pain, vulvar discomfort, or pain with intercourse be caused by vulvodynia or vaginismus?

Find out at our free Pelvic Pain patient seminar Thursday, July 21. Our team of experts will share the facts on pelvic pain that all women need to know and will answer your specific questions.

To reserve your spot, call 832-826-7376 or register online at https://bit.ly/PelvicPain7-21.