There is a lot of overlap (and confusion!) between three similar female conditions: Vaginismus, Vulvar Vestibulitis Syndrome, and Vulvodynia.

This understandable confusion comes from more than just the similarity between their names; these conditions are often found together, and sometimes the terms are used interchangeably. In fact, many University-level gynecological textbooks devote no more than a line or two to describing these individual gynecological disorders. That’s why having a specialist who knows the distinctions is so important.

Vaginismus: A tightening of the vagina, ranging from tightness with minor burning sensation to total closure, making penetration impossible.

Vulvodynia: Chronic pain around the vulva, characterized as burning, stinging, or irritating.  This can occur even during everyday activities.

Vulvar Vestibulitis Syndrome: Chronic pain caused by touch or pressure in the vestibule (entrance) of the vagina.

Vaginismus, then, is the closing of the vagina, while the latter two conditions deal with sensations of pain that are not caused by infection or skin disease. They can both can cause vaginismus, which contributes to the interchangeability-problem.

These conditions can be caused by a combination of physical and emotional factors: from physical trauma to emotional trauma, from physical abuse to sexual abuse, from autoimmune disorders to medications, the specific causes can vary from woman to woman. Prevalence has been estimated at 6% of the population in countries as different as Morocco and Sweden.

A common diagnosis technique for vulvodynia is the cotton swab test; women with this condition, or with vulvar vestibulitis syndrome, will experience severe pain and discomfort if a cotton swab is introduced into the vestibular area.

Some women have symptoms of abnormal tightness before the onset of puberty (called primary vaginismus) and others develop them later in life (secondary vaginismus).

Primary vaginismus has the added complication of removing the introduction of positive sexual experience to the woman’s life. Nobody is born with perfect sexual sensations; they are developed over time through healthy interactions. With a lifelong inability to have intercourse, women with primary vaginismus may fear the sexual situation so much that negative anticipation creates an immediate tightening sensation, contributing to the problem.

Women sometimes develop secondary vaginismus after childbirth, or after traumatic (physical or sexual) abuse. This makes emotional therapy just as important as physical therapy.

The good news is, vaginismus and its cousins are considered some of the most successfully treatable female sexual disorders. Treatment may include lifestyle and dietary changes, botanical and homeopathic treatment for the pelvis and the nervous system, and structural work to retrain the involuntary muscle reactions that are contributing to the problems. There is no uniform treatment that works for everyone; this makes a specialized approach even more important to the individual seeking treatment.

There are a few general guidelines to follow:

• Wear cotton underwear, instead of synthetic material
• Avoid irritating shampoos, perfumes, douches, and laundry detergents
• Gently rinse and pat dry after urination
• Sit on a pad to alleviate pressure
• Eat a diet low in oxalates (black pepper, parsley, spinach, cocoa, chard, and tea)

For women who need a personalized treatment program to overcome these curable symptoms, the naturopathic doctors at Grain are here to help.