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Vulvodynia and vaginismus

Vulvodynia / vaginismus · Vulvodynie a vaginismus

female only

What it is

Burning vulval pain with no visible cause, often set off by touch or sex; in vaginismus the pelvic floor clamps shut involuntarily.

Symptoms & signs

  • Burning or rawness at the vaginal entrance
  • pain with sex, tampons or tight clothes
  • constant ache in some
  • involuntary tightening on attempted penetration

🚩 Get help if…

  • see a doctor soon Sores, blisters or white patches on the vulva
  • see a doctor soon Unusual discharge or bleeding after sex
  • see a doctor soon A lump or thickened skin on the vulva
  • see a doctor soon Pain with fever or burning on passing urine

Where it strikes

Medical treatment

  • Exclude infection, skin disease and hormone lack
  • lidocaine gel
  • amitriptyline or gabapentin
  • pelvic-floor physiotherapy with dilators
  • cognitive behavioural and sex therapy
  • vestibulectomy in selected cases

Natural & lifestyle

  • Cotton underwear, no soaps or perfumes
  • lubricants
  • relaxation and breathing

Emerging & experimental

  • Botulinum toxin to the pelvic floor
  • low-level laser

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Low-oxalate diet — popular; one study found no link with oxalate mixed evidence
  • Acupuncture — small trials ease pain early / small studies
  • Mindfulness — small trials reduce pain early / small studies
  • Coconut oil as a lubricant — soothing; anecdotal anecdotal / traditional

ICD codes