Vestibulitis

Vestibulitis is a condition with pain and irritation of the area just outside of the vaginal entrance (vestibule). It can improve with treatment but can get worse at times.

The main symptom is pain.

Some people describe feeling swollen, while others have burning or stabbing pain or itching. Rarely, people with vestibulitis feel like they need to pee more often (urinary frequency).

Pain level can range from mild to severe. For most people, the pain comes and goes. For others, it can be daily and make it difficult to sit or walk.

For some people, pain gets worse when touching the area. Some people have pain with placing tampons or with penetration during sex.

Your doctor can diagnose vestibulitis during an exam. Your doctor will look for any redness in this vestibule. About 2 out of every 3 people also have visible red spots around the opening of the vagina. Sometimes, your doctor will test the sensitivity of the entrance of your vagina to light touch with a cotton-tipped swab.

No. There is no evidence that vestibulitis passes from person to person by having sex (it’s not an STI). People who are not sexually active can have this condition.

We don’t know the exact cause. Some doctors think it may be connected to:

• Excess moisture in the area outside the vagina (vulvar area)
• Vaginal and vulvar yeast infections
• An allergic reaction to an environmental irritant
• An autoimmune inflammatory response

You can apply topical steroid ointment to the affected skin to decrease irritation and redness. You may need to use the ointment for several months before seeing an improvement.

These medicines may help by interrupting the severity of the body’s nerve response. Some people with chronic pain experience depression, and this may help.

Topical lidocaine can temporarily numb a painful area to make an activity more comfortable (sitting for a long period or having sex). If you use this treatment, use a cotton swab or gloves to apply the jelly or wash your fingers right after you apply it. This prevents your fingers from getting numb.

You can soothe the pain by soaking in warm baths with plain water, Epsom salts or oatmeal. Ice packs may also decrease pain.

When it is painful to touch the vaginal entrance, a natural reflex is to tighten the pelvic floor muscles. This tightening can make it harder to use tampons or have sex. Pelvic floor physical therapy can help you learn to tighten and relax these muscles.

Learning to reduce stress can help decrease pain and improve coping skills.

Vaginal yeast infections can make pain worse. If you have a yeast infection, you may need antifungal treatment. If yeast infections keep coming back, you may need treatment to prevent yeast infections.

Wear cotton underwear and loose clothing. If you normally wear tights, try cutting out the crotch area or switch to socks. When you do not have your period, sleep without underwear to air out the area.

Use white, softer, non-perfumed toilet paper.

Laundry detergent can cause the clothes you wear to be an irritant. You may want to try using a different detergent, such as:

• Dreft
• Baking soda soap
• Other products advertised as dye- and fragrance-free or hypoallergenic

Avoid getting any soap on your vaginal area when bathing or showering. When showering, lean forward to rinse out your hair, so the shampoo does not run into your vulvar area. If you take a bath and there is soap residue in the bath water, rinse your vulvar area with clean water before you get out. After drying off, use a blow dryer on low heat to dry the area.

You can use water-based lubricant with condoms. But you cannot use any oils with most condoms – they will break. Tracking your symptoms may help you choose the product that works best for you.

• Pure coconut oil
• Vegetable oil
• Water-based lubricant (Astro-Glide or K-Y Jelly)

Some contraceptive devices (such as latex condoms) and creams can irritate the vulva. For people with a latex allergy, non-latex condoms are an option. Talk with your provider to discuss your birth control options.

Avoid products around the genital area that can cause irritation, such as:

• Perfumed soaps
• Oils (except the lubricants listed above during sex)
• Skin creams
• Lanolin
• Bubble baths or bath oils
• Feminine deodorant sprays
• Perfumed menstrual pads

Staying in wet bathing suits or underwear can make vestibulitis worse. Water from swimming pools can be especially irritating. Before swimming, put petroleum jelly (Vaseline) on the area. When you get out, use a spray bottle of water to rinse the area and dry it using a blow dryer on low heat.

Please call us at 206-987-2028 option 4, if:

• Your pain is getting worse.
• You have questions.