Severe pain and discomfort in the vestibule area of the vulva. The vestibule is where the vulva (area of the skin on the outside) meets with the vagina. It is an extremely sensitive part of your body and contains the Bartholin's gland (which produces vaginal lubrication), the urethra (where you pass urine) and a few the small minor vestibule glands which also produce vaginal discharge.
Pain is experienced as burning and soreness in the vulva or the vestibulum. The sensation of burning and soreness of the vulva can be continuous (unprovoked vulvodynia), or on light touch, e.g. from sexual intercourse or tampon use (provoked).
The pain can also be experienced in the inside of the thighs, upper legs and even around the anus (back passage) and urethra (where you pass urine). Women also have pain when they empty their bowels. Unprovoked Vestibulodynia can influence sexual activity and is associated with pain during foreplay and penetration.
Vaginismus is the result of an involuntary vaginal muscle spasm, which makes any kind of vaginal penetration painful or impossible e.g. sexual intercourse, gynaecological exams and even tampon insertion.
Persistent Genital Arousal Syndrome (PGAD)
- Persistent genital arousal disorder (PGAD) is a phenomenon where women experience spontaneous genital arousal without stimulation, unresolved by orgasms eliciting stress. - The primary symptom of PGAD is a series of ongoing and uncomfortable sensations in and around the genital tissues, including the clitoris, labia, vagina, perineum, and anus.
Pudendal Neuralgia
- Pudendal Neuralgia is a pelvic pain syndrome causing sharp, shooting, or burning pain in the territory of the nerve. - Pain can be around the skin of the vulva, labia, and clitoris as well as the perineum, anus and a portion of the urethra, and part of the rectum and vagina, and most of the pelvic floor muscles.
Lichen Sclerosis and Pelvic Pain:
Lichen Sclerosis appears as white thin patchy skin around the vulva and anus. An overactive immune system or an imbalance of hormones may play a role. Previous skin damage at a site on your skin may increase the likelihood of lichen sclerosis at that location. Lichen sclerosis is not contagious and cannot be spread through sexual intercourse.
Severe, episodic pain in the regions of the rectum and anus. It can be caused by spasm the pelvic floor muscle.
Pain and tenderness at the tip of the tailbone between the buttocks. It can be caused by an injury e.g. during a fall, prolonged sitting on a hard or narrow surface, degenerative joint changes, or vaginal childbirth, but may occur seemingly spontaneously.
There are many other causes of tailbone pain which can mimic coccydynia, including sciatica, infection, pilonidal cysts, or a fractured bone.
Consultation and Treatment
A pelvic floor physiotherapist is a trained expert in the pelvic floor anatomy, as well as the entire musculoskeletal system. By performing an external and internal examination and assessment of the external and internal anatomy, she can help women strengthen the muscles that have been stretched, torn and weakened during pregnancy and childbirth and help with down training a hypertonic pelvic floor (muscle that is not relaxing). Like injuries to any other part of the body, physiotherapy can help ensure that the tight or weak/ damaged structures return to their optimal function.