There are many potential causes for pain or discomfort in the vulvar region or the vaginal canal. Conditions and dysfunction in the pelvic region can be tricky to describe and are often interrelated. You will want to work with your health care provider to correctly diagnose your specific issue, but working from a place of basic understanding of your body and symptoms is immensely helpful in getting the right treatment for you.
Click here for a basic questionnaire-style guide to help you understand and describe your symptoms. This is a great exercise to do in preparation for a visit with your healthcare provider, and while it refers to pain during penetration, is relevant to those who notice symptoms but are not engaging in penetrative sex. Feel free to bring this and any information from this website or our sister web resource (A Woman’s Touch Sexuality Resource Center) along with you to help you communicate your experience to your doctor.
Below is a brief explanation of some common conditions and disorders organized by major symptoms.
Vaginal Pain or Discomfort
SYMPTOMS: A closure of the vaginal opening that is stiff and located about 1 1/2 inches inside the vagina. Many women describe this feeling as “hitting a wall,” and often notice this during attempted penetration or pelvic exams.
This may be a condition called “Vaginismus“. Vaginismus is an unconscious spasming of the pelvic floor muscles that surround the opening of the vagina. It happens even when you are engaging in what you would consider to be consensual, pleasurable penetration of the vagina, and feels like a strong ring or wall at the opening.
Vaginismus happens for a variety of reasons. In many cases, this condition develops as a result of physiological and psychological protection mechanisms enacted as a response to painful or unwanted penetration or pelvic exams. Read more about causes and treatment options on our sister website.
Vulvar Pain or Discomfort
SYMPTOMS: Burning, stinging, irritating raw feeling of the vulva. Usually these sensations feel close to the surface of the skin and tissues, as oppose to a deep muscular discomfort.
“Vulvodynia” is a word that describes a variety of conditions. Three different sub-types have been described, and have different treatment approaches:
- skin disease,
- inflammation of the vulvar opening, and
- irritation of the nerves that serve the vulva.
Vulvodynia is a diagnosis made after other diagnoses, such as vaginal infections, neuropathies, sexually transmitted infections, and other dermatological conditions are tested for and found not to be the cause. If you have an actual sore or scab patch on your vulva, you very likely need a series of biopsies to diagnose the problem. (One biopsy isn’t enough: it usually takes three biopsies minimum to determine a diagnosis.) Even when health care providers have extensive genital dermatological experience, the good providers will get a biopsy to confirm the diagnosis. Click here to read more about each sub-type through our sister website.