Vestibulitis is a condition that causes chronic pain in the vulva, the external portion of the female genitals. In vulvar vestibulitis syndrome, women experience inflammation and pain in the area around the opening to the vagina called the vestibule. Vestibulitis may occur anytime a woman has vaginal penetration, or it may develop after having pain-free intercourse for a while, according to the National Vulvodynia Association.
Vestibulitis often causes burning sensations in the vaginal area known as the vestibule. The skin in the vestibule may feel tight, raw and dry. Symptoms of vestibulitis usually occur when the vestibule is externally irritated, such as when a woman has intercourse, inserts a tampon, rides a horse or wears tight clothing.
The severity of vestibulitis varies from person to person. In some women, it may be mild and occur only during sex; in other women, vestibulitis may be severe, making it impossible to have intercourse or even sit or walk without severe pain and swelling. Flare-ups, sudden periods of worsened symptoms, and remission, periods when symptoms are reduced or do not occur, are common in women with vulvodynia and vestibulitis.
A diagnosis of vestibulitis occurs after a doctor obtains a thorough medical history and carefully examines a woman's genital area. The doctor will take cultures of vaginal secretions to rule out infections that may cause symptoms similar to vestibulitis, such as bacterial and yeast infections. In some cases, a physician may take a biopsy, or small sample of cells, to check for skin problems that may help determine a diagnosis. The doctor also might apply gentle pressure to the genital area while asking the patient to rate her pain severity.
Treating vestibulitis may reduce or eliminate symptoms. Oral medications can be taken to reduce inflammation and nerve irritation. Topical creams may be used to moisten the genital tissues, and antifungal creams can help if yeast infections are causing symptoms. In rare cases, surgeons remove the oversensitive tissue that causes pain and burning symptoms.
To avoid inflammation that makes vestibulitis worse, it can be helpful to wear loose clothing and cotton underwear. Avoiding soaps, lotions and oils containing fragrance may help reduce symptoms, as can rinsing the vulva with a bidet or squirt bottle after urination. Exercising and eating a diet rich in fruits, vegetables and fiber can help because it reduces constipation, which may irritate the vulvar area. Those with vestibulitis also might be advised to avoid eating foods high in oxalates. These byproducts of metabolism are acidic and may aggravate vestibulitis symptoms when they are excreted in the urine. The Interstitial Cystitis Association recommends avoiding high-oxalate foods including beans, beer, beets, berries, celery, chard, chocolate, eggplant, some grapes, green peppers, peanuts, rutabaga, spinach, squash and tofu.