Vaginismus vs Vulvodynia

Roma Kunde
Roma Kunde
August 6, 2024
8
min read
Medically reviewed by:
Trager Hintze, PharmD
Vaginismus vs Vulvodynia
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Women’s pelvic health conditions can be complex and confusing to diagnose. Distinguishing between vaginismus vs. vulvodynia and vestibulodynia can help you accurately diagnose and treat these conditions.

What Is Vulvodynia?

Vulvodynia is a painful, long-term condition that affects the vulva or the external female genitalia. It causes pain, discomfort, burning, stinging, or soreness in the area without any obvious physical cause. The pain may be continuous or intermittent and can worsen if you touch or put pressure on it [1].

What Is Vulvar Vestibulitis?

Vulvar vestibulitis or vestibulodynia is a painful condition that affects the vestibule, which is the area of the vulva around the vaginal opening. Vestibulodynia is a type of vulvodynia where the vulva’s vestibular area gets inflamed or swollen [2].

What Is Vaginismus?

Vaginismus occurs when the muscles around the vagina, or the female genital opening, involuntarily tighten or spasm when something penetrates it. This can make sexual intercourse, gynecological exams, or tampon use painful or difficult [3].

Vaginismus vs. Vulvodynia

Vaginismus and vulvodynia both affect the female genital area and cause pain and discomfort, but they differ in their causes, symptoms, and treatment.

Causes

Vaginismus is often due to psychological factors like anxiety or trauma. This causes the muscles around the vaginal opening to tighten and hurt [3].

In contrast, the exact cause of vulvodynia is unclear, but it may involve factors like nerve irritation, inflammation, hormonal changes, or pelvic muscle issues [1]. When the pain is localized to the vestibule, it’s called vulvar vestibulitis or vestibulodynia. An overgrowth of nerve fibers in the vulva can also cause pain and sensitivity, leading to a subtype of vestibulodynia known as neuroproliferative vestibulodynia [2].

Symptoms

Here’s how to differentiate between vaginismus vs. vulvodynia symptoms.

If you have vaginismus, your vaginal muscles involuntarily tense or tighten during penetration, which can be painful, especially during sex or when inserting a tampon or gynecological probe [3].

Conversely, vulvodynia involves pain or discomfort in the vulva that may persist or come and go. In rare cases, if the pain is localized in the vestibule, you might also notice small skin-colored bumps known as vulvar vestibulitis bumps [1, 4].

Vaginismus causes involuntary vaginal muscle tightening, often from psychological factors, while vulvodynia involves vulvar pain linked to nerve irritation or other physical causes.

Treatment

Treatment for vaginismus may include topical pain relievers and counseling to address psychological factors like anxiety and trauma contributing to the condition. This can be combined with vaginismus physical therapy, including pelvic floor exercises for vaginismus, to help relax and control the muscles in the vaginal area [3].

If you have vaginismus, pregnancy can be physically and mentally challenging. Consult your doctor to manage vaginismus and pregnancy. They may also modify vaginismus exercises for pregnancy and provide guidance for safe and effective care [3, 5].

Vulvodynia and vulvar vestibulitis treatment includes medications and topical treatments to reduce pain and inflammation. Physical therapy can also help ease your pain. New treatments for vulvodynia include Botox and anti-inflammatory topical gels. Acupuncture is also an option, but you must choose an experienced practitioner [1, 2, 6, 7].

Additionally, dietary changes can help you manage vulvodynia symptoms. Foods to avoid with vulvodynia include spinach, beets, peanuts, and chocolate. They contain oxalates, which can increase inflammation and worsen your vulvodynia symptoms [6, 8].

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Can Vulvodynia Feel Like a UTI?

Vulvodynia can mimic the symptoms of a urinary tract infection (UTI), leading to confusion between the two conditions. Both vulvodynia and UTIs can cause symptoms such as chronic pain, burning, and irritation. These overlapping symptoms make their diagnosis challenging.

However, here’s how you can tell the two conditions apart [1, ], [9]:

  1. Vulvodynia pain is localized in the vulva, whereas UTI pain and discomfort are typically felt in the bladder, urethra, and lower abdomen.
  2. Vulvodynia often causes burning with touch or pressure, while UTI-related burning usually occurs when you pee.
  3. If you have a UTI, you’ll pee more frequently and urgently and notice cloudy urine, which is not seen in vulvodynia.
  4. You can check for UTIs using a urine test, which detects bacteria or white blood cells. Vulvodynia is not an infection and is diagnosed by excluding other conditions.
  5. If you have a UTI, prescribed antibiotics will offer you quick relief. However, vulvodynia requires topical treatment and pain management.

Importance of Proper Diagnosis

Proper diagnosis can help you differentiate between vulvodynia vs. vaginismus and not confuse them for UTIs. It can help ensure you get the right treatment, such as antibiotics for UTIs or pain management for vulvodynia. It also helps you identify the underlying cause of your symptoms, which can help prevent prolonged discomfort and improve your quality of life [11].

At-Home Testing With Diagnox

If you're still unsure about your symptoms, try Diagnox’s at-home testing products like Vaginox and Urinox-UTI test kits. They are useful tools to check your vaginal pH and urinary parameters and detect problems early.

The Vaginox kit helps monitor your vaginal pH, which can indicate issues such as bacterial vaginosis or yeast infections, while the Urinox-UTI kit checks various urinary parameters, helping to detect urinary tract infections and other potential concerns early. These convenient, easy-to-use tests allow you to take proactive steps in understanding your health from the comfort of home, providing valuable insights to guide further discussions with your healthcare provider.

Get these convenient testing kits today for your peace of mind. If you have concerns, consult your doctor for a thorough evaluation.

References

[1] Mayo Clinic Staff, “Vulvodynia,” Mayo Clinic. [Accessed August 6, 2024].

[2] Cleveland Clinic Staff, “Vestibulodynia,” Cleveland Clinic. [Accessed August 6, 2024].

[3] Cleveland Clinic Staff, “Vaginismus,” Cleveland Clinic. [Accessed August 6, 2024].

[4] S. Kakkar and P. K. Sharma, “Benign vulvar vestibular papillomatosis: An underreported condition in Indian dermatological literatureIndian Dermatol. Online J. vol. 8, pp. 63-65, Jan-Feb 2017.

[5] R. Achour, M. Koch, Y. Zgueb, U. Ouali, and R. Ben Hmid, “Vaginismus and pregnancy: epidemiological profile and management difficultiesPsychol. Res. Behav. Manag. vol. 12, pp. 137-143, March 2019.

[6] National Vulvodynia Association Staff, “Vulvodynia Treatments,” National Vulvodynia Association. [Accessed August 6, 2024].

[7] F. De Seta, P. Ianniello, S. Carlucci, L. Nappi, F. Sorrentino, and G. Stabile, “New Topical Therapy for Provoked Vestibulodynia: Improvement of Psychological and Sexual Well-Being,” Int. J. Environ. Res. Public Health. vol. 20, pp. 1931, Jan 2023.

[8] Mount Sinai Staff, “Vulvodynia,” Mount Sinai. [Accessed August 6, 2024].

[9] Health University of Utah Staff, “Vulvodynia,” Health University of Utah. [Accessed August 6, 2024].

[10] NHS Staff, “Urinary tract infections (UTIs),” NHS. [Accessed August 6, 2024].

[11] NIH Staff, “Improving Diagnosis in Health Care,” NIH. [Accessed August 6, 2024].

About the Author
Roma Kunde

Roma Kunde is a freelance content writer with a biotechnology and medical background. She has completed her B. Tech in Biotechnology and has a certificate in Clinical Research. She has 6 years of writing and editing experience in fields such as biomedical research, food/lifestyle, website content, marketing, and NGO services. She has written blog articles for websites related to construction chemicals, current affairs, marketing, medicine, and cosmetics.

About the Reviewer
This blog was
Medically reviewed by:
Trager Hintze, PharmD

Trager Hintze is a clinical assistant professor and emergency medicine clinical pharmacist located in College Station, Texas. He has a bachelor's degree in biology as well as a Doctor of Pharmacy degree. He balances teaching at Texas A&M University College of Pharmacy and practicing emergency medicine at St. Joseph Regional Health Hospital.

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