Vulvodynia, Vestibulodynia and Clitorodynia Treatment

Have you put up with your pain long enough?

​Our experienced physiotherapists can help you manage Vulvodynia, vestibulodynia and clitoridynia problem and get back to your life! We have been successful treating this problem both in-clinic and online.

WHAT IS IT?

Vulvodynia is a term used for chronic (lasting longer than 3 months) discomfort and pain, most commonly described as burning or soreness in the vulvar area. Some women report sensations of itching, aching, stinging or throbbing. Vulvodynia can be generalized, meaning it is felt all over the vulvar area, or localized to a specific areas. Vestibulodynia is the term used for pain at the vestibule (opening) of the vagina. Clitorodynia refers to pain around the clitoris.

There are different types of vulvodynia/vestibulodynia. It can be unprovoked, where the pain is continuous and can occur spontaneously. Provoked vulvodynia/vestibulodynia is the term applied with the pain is caused by light touch or pressure to the area from activities such as sexual intercourse, tampon insertion, gynaecologic examination, prolonged sitting or wearing tight pants. The pain intensity can vary from mild to severe, and may occur outside the vulvar area as well.

WHAT CAUSES IT?

Vulvodynia and its subclassifications are not caused by a skin disease or infection. It is suggested that several factors related to hormones, the immune system, irritation or hypersensitivity of vulvar skin nerve fibres, an increased number of nerve endings in the vulvar vestibule, genetic susceptibility, and pelvic floor muscle weakness or spasm are involved. Since the problem lies with the nerve fibres, there is usually nothing visible on the skin.

Vestibulodynia can begin from the first sexual intercourse or later, due to a recurrence of vaginitis or trauma in the area or for no apparent reason.

The causes of vestibulodynia are multifactorial. A lack of lubrication and a tight pelvic floor are biological factors frequently involved in genito-pelvic pain. Certain emotional factors such as stress, fear of intimacy, fear of pain, anxiety or depression can impact the symptoms and perception of pain. In fact, all of your thoughts, emotions and behaviors play an important role in your perception of pain. Finally, the last research on genito-pelvic pain indicates that the partner has an impact on the perception of the pain felt by the woman, both positively and negatively, and that the pain has consequences on the partner, as well as on the couple's relationship.

Finally, trauma experienced in childhood, such as abuse and neglect, are risk factors for developing induced vestibulodynia during adulthood.

HOW CAN PHYSIO HELP?

Since the cause of vulvodynia is unknown, treatment is directed toward pain and symptom relief. Products with dyes or perfumes and clothing that is non-cotton may be irritating for the vulvar region, so avoiding them is a good first step. Cold gel packs may help reduce the pain when it is experienced.
 
Since the pelvic floor musculature may be involved, physical therapy may be recommended. Pelvic floor muscle re-education can help release muscle tensions and relax the pelvic floor tissues. Trigger point therapy may be used. Treatment can also focus on strengthening the weakened muscles, which may contribute to lessening the pain. It is important to keep in mind that no one treatment or combination of treatments works for all women, and that finding the right one may therefore take some time.
 
Combining pelvic floor treatments with counseling consultations helps you have all the tools you need to better understand your pain and improve your situation. 

HOW CAN PHYSIO SEXO?

Your sex therapist can support you in your quest for intimate, sexual and/or relational well-being. Although this is a process for couples, it is possible to consult individually, while making sure to reach your partner through exercises to be done between sessions.

Your sex therapist will be able to identify with you the causes of your pain and how it affects your relationship as a couple. It's important to understand that no technique will instantly take away the pain you feel. However, your sex therapist will work with you to develop pain management tools, which can be broken down into 3 areas: learning to control pain, accepting that pain is part of your life, and addressing partners' emotional reactions to pain.

She uses a variety of approaches that recognize that you are the expert in your own reality, and that you have all the resources within you to achieve your well-being. The sex therapist will guide you through this journey, using her knowledge, know-how and skills, while proposing practical exercises to be carried out during and between sessions.

Combining pelvic floor treatments with counseling consultations helps you have all the tools you need to better understand your pain and improve your situation. 

Treatment Options

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