Vulvar vestibulitis and vulvodinia, while both affecting the female intimate area, are two problems that should not be confused with each other. But they are in any case not so distant syndromes from each other. Vulvar vestibulitis, in fact, if not diagnosed and treated in time, becomes chronic, paving the way for vulvodinia. We discuss this with Dr. Alessandra Valerio, a specialist in gynecology and obstetrics in Ferrara.
Three different conditions, one pain
“To correctly frame the various problems affecting the female genital area, it is first important to clarify the terms that indicate them,” the expert points out. “Vulvar vestibulitis, just as the suffix “ite” suggests, is an inflammatory condition of the vestibulum, the anatomical area bordered by the inner face of the labia minora where the urethral meatus and vaginal introitus are located. Instead, we speak of vestibolodinia when there is a chronic painful condition of the vestibulum, and of vulvodinia when chronic pain affects the vulva. In essence vestibolidinia and vulvodinia are different localizations of the same clinical entity with a common denominator being persistent pain. In the former case, the pain is concentrated at the level of the vestibule and may be produced, for example, as a result of rubbing during sexual intercourse, more intense in the presence of a condition of vaginal dryness, while in vulvodinia the pain is often present even without there necessarily being a triggering element.”
From vestibulitis to vulvodinia
It could be said that the step is short. Or rather that it becomes so should certain conditions arise. “Vulvar vestibulitis, while an inflammation that can regress, tends to become chronic if it is not diagnosed and treated in time,” the gynecologist points out. “It thus happens that a painful condition that could be only momentary if treated in a timely and correct manner, risks becoming chronic by transforming into vestibolidinia, which is nothing more than a form of localized vulvodinia.” Only early diagnosis and treatment thus prevent a worsening of vestibulitis, interrupting the vicious cycle of pain and allowing to arrive at a healing, more or less rapid but always possible. Which, it must be acknowledged, is often not easy since vestibulitis can in several cases be associated with predominantly inflammatory urinary disorders such as recurrent cystitis making the picture even more complex, both from the point of view of diagnosis and treatment, and contributing to intensification and chronicity of the painful condition
A complex of causes
Vestibulitis and vulvodinia can also be on the same plane in terms of their underlying causes (https://stopvulvodinia.com/le-cause-della-vulvodinia/). “These are often concurrent causes, but the etiology is still usually multifactorial,” the gynecologist explains. “One of these is thehyperactivity of mast cells, cells deputed to defense, which causes a chronic inflammatory state in turn favored by recurrent infections, microtraumas also related to sexual intercourse, incorrect hygienic habits. Hyperactivation of mast cells determines, for another, an increased sensitivity to painful stimuli that leads to a muscular reaction with a permanent spasm of the pelvic floor muscles. Thus we enter a vicious circle where pain causes contracture, which in turn increases the painful sensation also because it reduces oxygenation of the tissue, which becomes increasingly rigid: pain ends up becoming a permanent condition with what negatively this can also entail in terms of quality of life.”
The importance of daily attention
“Vestibulitis is an inflammatory condition that can be treated and resolved by providing a personalized treatment plan that the physician can draft based on a careful history taking into account predisposing and aggravating factors, severity and duration of symptoms,” comments Dr. Valerio. “The more targeted and timely the intervention, the more successful it is in preventing the pain from becoming chronic and the condition from evolving into a more complex syndrome. In any case, precisely in order to prevent vestibulitis from turning into an vestibolodinia, it is necessary to keep in mind that daily habits play a key role. Therefore, it is important to adopt an accurate but not excessive intimate hygiene routine, avoid aggressive or perfumed cleansers preferring formulas with pH close to the physiological one for age, do not use intimate wipes, depilatory creams, deodorants on the vulva, limit the use of panty liners, choose cotton pads for the menstrual period, and use cotton and not synthetic underwear. It is also useful to take care of the diet by avoiding foods rich in sugars and yeasts that promote Candida recurrences and complicate the clinical picture.”