Vestibulodynia/Vulvodynia (Vulvar Pain)/Vaginismus

Vulvodynia is discomfort in the vulva usually described as burning pain which occurs in the absence of relevant visible findings or a specific clinically identifiable neurological disorder.

Vestibulodynia was first identified over 100 years ago. Edouard Friedrich developed the following criteria in 1987:

• severe pain on vestibular touch or attempted vaginal penetration
• tenderness to pressure localized within the vular vestibule
• physical findings limited to vulvar redness/swelling

Sometimes vestibulodynia is association with other conditions such as irritable bowel syndrom, urethral syndrome or interstitial cystitis.

Vaginismus is a condition where vaginal penetration is impossible due to pelvic muscle spasm, pain, fear or disgust. Sexual intercourse is impossible as is insertion of a speculum to have a PAP test.

All of the above conditions result in hypertonicity of the pelvic floor muscles with poor control and strength in the pelvic floor muscles.