Vulva vestibulitis or localized provoked vulvodynia (LPV) is when there is pain in your vestibule, the portion of the vulva surrounding the opening of the vagina. Characterized by a stinging or burning-like pain at the vaginal opening, it’s typically provoked by sexual intercourse and the insertion of objects such as a tampon or speculum into the vagina. Sometimes it can be present during daily activities. Vulva vestibulitis can cause redness and irritation of the skin as well as pain in the glands inside the skin.

Classified as a “neuro-inflammatory” condition, vulva vestibulitis involves inflammation which causes pain as the nerves that are involved in sensing pain releases chemicals that promote inflammation, thus causing further pain. Careful examination can reveal redness and unusual sensitivity of the tissue of the vulva.

Vulva vestibulitis usually develops between the ages of 20 and 50, and although it is not caused by any single factor, it can often appear after an infection of the lower genital tract, become aggravated by acidic foods, or low levels of estrogen.

Symptoms vary in everyone and can be mild or serious to impact your daily life and sexual life. Symptoms may or may not be constant and include:

• Pain from pressure like sitting, working out, tight clothes, or touch
• Pain from sex
• Pain from using a tampon
• A burning sensation in the vulva
• Stinging sensation in the vulva
• Feeling raw
• Urinating frequently or a sudden feeling like you have to urinate
• Unusual or irritating vaginal discharge
• Small red spots around the vestibular glands

Current treatments include:

• Q-tip test: To test for similar pain that a woman could be experiencing, a cotton bud or swab can be pressed onto the vestibular skin to provide a painful sensation.
• A combination of estradiol, an estrogen hormone, and lidocaine, a local anesthetic, is compounded and applied.
• Anti-neuropathic analgesics and steroid infiltration into the opening of the vagina may be offered.
• Pelvic floor therapy: pelvic floor muscles supports the bladder, uterus, and bowel. Pelvic floor therapy aids in strengthen the pelvic muscles.
• Fenton’s vestibulectomy: the removal of the vestibule or the back wall of the vagina’s tissue. The posterior vaginal wall is then advanced downwards and sutured into position.

If you think you may suffer from Vulva Vestibulitis, consult with your OB/GYN.