Vulvar vestibulitis - is an inflammation of the tissues surrounding accesses to the vagina. In fact, the vestibulitis affects the mucous membrane of the vestibule and the vulva located inside the labia and around the outer edge of the hymen. The disorder is caused by many reasons that often interact with each other, thereby only aggravating the patient's condition.
Causes of vestibulitis
Let us dwell in more detail on the causes of vestibulitis. The occurrence of the disease is significantly affected by hyperactivity of the immune system. This reaction is caused by prolonged exposure to the irritating factor responsible for excessive local immunity. Hyperactivation of mast cells of the immune system can be supported by:
- infectious agents such as Candida, Gardnerella or E. coli (from the intestines);
- vaginal injuries during intercourse due to insufficient lubrication;
- estrogen deficiency;
- the use of aggressive detergents during sexual hygiene;
- wearing tight-fitting synthetic underwear;
- hypertonicity of the pelvic floor muscles.
Vulvar vestibulitis can manifest itself as a defensive reaction of the vaginal area, causing a constant muscle spasm. Also, the disease is often complicated by the presence of inflammatory urological conditions(cystitis).
Symptoms of the vestibulitis of the vulva
There are three main symptoms: redness, burning and pain during intercourse. Redness (erythema) is of varying degrees, but is always at very specific vestibular points.
Observing in the mirror, you can notice a more intense redness from the base of the clitoris to the medial border of the labia. If you mentally imagine the vestibule of the vagina in the form of a clock, then the burning sensation is localized between the «five» and«seven».
Diagnosis and treatment of vestibulitis
The vestibulitis of the vulva is diagnosed on the basis of anamnesis and gynecological examination. Physical examination reveals localized redness, indicating an inflammatory process.
Treatment of vestibulitis includes various approaches, the purpose of which is to reduce pain. To mitigate the manifestation of the condition, first of all, it is necessary to avoid the influence of irritating factors (tight underwear, aggressive detergents for personal hygiene).
Local anesthetics (with lidocaine), sodium cromglicate (stabilizes the membranes of white blood cells and mast cells, interrupting the process of neurogenic inflammation) will help relieve pain. The use of tricyclic antidepressants and anticonvulsants is sometimes indicated. In severe cases, there is a need for surgical intervention to remove the nerve endings, the proximal edge of the vagina, the inner part of the labia minora.
Experimental treatment includes the local administration of botulinum toxin type A. Along with a direct therapeutic approach, it is also advisable to refrain from sexual relations during an exacerbation of the disease.