Vulval vestibulitis syndrome
With vulval vestibulitis syndrome, you experience severe pain when the opening of the vagina (the ‘vestibule’) is touched. The syndrome usually comes on quite suddenly, and is most common in women in their 20s or 30s. It is very distressing because, as well having to cope with the pain, your sex life is probably zero and it can even prevent you using tampons, wearing jeans or riding a bike.
The cause of vulvar vestibulitis is not known. Some experts think the nerves of the genital skin become oversensitive. Research from Sweden, published in the British Journal of Obstetrics and Gynaecology in 2001 (2001;108:456-61), suggests that women with vulvar vestibulitis tend to be oversensitive and worry about things that may never happen. So perhaps your brain is over-alert to signals from the nerves of the vulval skin.
What can be done about vulval vestibulitis syndrome
* Look at the Common sense dos and don’ts for vulval problems.
* Teabags (Indian tea) or Earl Grey contain tannic acid which is a local anaesthetic and can calm the burning sensation of vulval vestibulitis. Put teabags in the bath, or put a cold, damp teabag on the sore area at night.
* You may be able to soothe the area by applying vitamin E oil (which you can squeeze out from capsules of vitamin E).
* Aqueous cream is a plain, soothing, perfume-free cream that you can buy from pharmacies. Many women with vulval vestibulitis find that aqueous cream helps by soothing and rehydrating the skin. Use it cold, by storing it in the fridge. Unlike steroid creams, you can use it as often and for as long as you like.
* Xylocaine gel contains a weak amount of the local anaesthetic lignocaine. It numbs the nerves in the skin and can be used safely on a regular basis. Although it does not cure the problem, it will allow you to have sexual intercourse comfortably if you apply it 15 minutes beforehand.
* You could try a diet that is low in oxalate, a plant chemical. The evidence that this works is scanty, but some women find it helpful. This means avoiding beetroot, chocolate, cola drinks, cranberries, nuts, rhubarb, soya foods, spinach, strawberries, tea and wheat bran.
* As with vulvodynia, tricyclic antidepressant medication often helps. This is not because you are depressed (or imagining the condition), but because these drugs suppress transmission in nerves of the skin. So talk to your family doctor.
* As with vulvodynia, ask your family doctor if your local hospital has a ‘vulval clinic’ that you could be referred to. Some clinics use a technique called ‘electromyographic feedback from pelvic floor muscles’, which is a method of training your nervous system to stop sending the pain signals.
