Sex and Sexuality

Anatomy of An Irritated Vestibule

By Riva Preil

Vestibulodynia (VBD, also called vulvar vestibulitis or vestibulitis) is a specific type of vulvodynia (refer to “Vulvo-what-ia?â€, November 26 blog for details). Both are considered chronic pain syndromes involving hypersensitivity of the central nervous system. Whereas vulvodynia is believed to be caused by direct nerve injury, VBD is most likely due to repetitive inflammation around the nerve which interferes with the normal transmission of messages through the central nervous system. New connections are made between receptor cells, the spinal cord, and the brain, and ordinarily non-noxious (non-painful) stimuli send messages to the brain which scream “PAIN!†loud and clear. Therefore, tight jeans, wiping after toileting, water pressure while showering, cycling, gynecological speculum examinations, tampon usage, and intercourse may become very painful for an individual with VBD.

VBD can be sub-divided into primary VBD and secondary VBD. Primary VBD refers to pain with the first attempt at vaginal penetration (either when first attempting to use a tampon or when an individual becomes sexually active). Women who experience this generally suffer from other forms of painful conditions such as urinary dysfunction, constipation, irritable bowel syndrome (IBS), temporomandibular joint (TMJ) dysfunction, interstitial cystitis (IC), or fibromyalgia. Secondary VBD refers to the development of pain with penetration after successfully tolerating pain free tampon usage or intercourse. It is believed that certain triggers may be connected with the development of VBD, such as yeast infection, frequent urinary tract infections (UTI), human papillomavirus (HPV), or herpes, to name a few. To be continued…

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