Do you experience burning, stinging or rawness in your vulvar area? Maybe you feel itching, throbbing, or aching in the perineum and pelvis. You are not alone. These symptoms are typical of vulvodynia.
Vulvodynia is a pain condition of the female genitals: clitoris, vestibule (vaginal opening), labia, and perineum.
There are two main subtypes of vulvodynia:
- Generalized Vulvodynia is pain in different areas of the vulva. Pain occurs spontaneously and can be relatively constant. Activities that apply pressure to the vulva, such as prolonged sitting, wearing pants, riding a bicycle typically make the symptoms worse.
- Vulvar Vestibulitis Syndrome (Provoked Vestibulodynia) is pain in the entrance to the vagina, (vestibule). Often a burning sensation, this type of vulvar pain comes on only after touch or pressure, such as during intercourse or placing a tampon. This type is further classified as Primary: pain experienced with first attempt of vaginal penetration, or Secondary: woman has experienced pain free penetration prior to the development of pain.
Vulvar Vestibulitis Syndrome
Self Care Strategies
Self-care and treatments for vulvodynia can help bring relief and recovery. Unfortunately, there is not a "one size fits all" treatment. Working with a trained healthcare provider who understands vulvodynia is crucial to getting out of pain. Here are a few suggestions to alleviate symptoms:
Avoid Irritants to the vulvar tissue
- Use dermatologically approved detergent and don’t use fabric softener.
- Use unscented toilet paper that’s soft and white.
- Wear 100% white cotton underwear, menstrual pads, and tampons.
- Avoid getting shampoo on the vulvar area.
- Avoid perfumed creams or soaps (no Massengill or Summer's Eve cleaning products), pads or tampons, and contraceptive creams or spermicides.
- Avoid hot tubs or pools with lots of chlorine.
- Rinse the vulva with cool water after urination and intercourse.
- Avoid foods that make urine more irritating. This may include foods such as greens, beans, berries, chocolate, or nuts.
- Wear loose-fitting pants and skirts; don’t wear pantyhose.
- Keep the vulva clean and dry.
Relieve pain and ease pressure
- Use a water-soluble lubricant during sex. Olive and coconut oil can also be used as a lubricant.
- Avoid activities that put direct pressure on the vulva. This includes bicycling and horseback riding. Intense exercise that creates friction at the perineum.
- Learn how to sit with a neutral pelvis, this decreases pressure on the coccyx and tailbone. LImit sitting time to 20 minutes, then get up and move around.
- Soak in lukewarm or cool sitz baths.
- Apply heat, ice or a frozen gel pack wrapped inside a hand towel.
- Relaxation techniques and walking can improve blood flow, increase circulation and calm the nervous system.
Make an appointment with your local Pelvic Health Physical Therapist
This Saturday, September 22 marks the beginning of Fall. The change of seasons here in Salt Lake City is invigorating: brisk mornings and evenings require putting on layers, and the leaves are turning orange, yellow and red. This change feels so synchronized, steady and effortless.
If only changing habits and behaviours could be so elegant...
A transition of seasons may appear effortless, because of the consistency in change month after month. We can
apply this concept of change to our own habits and behaviours: big changes most often happen from a sequence of small solutions strung together.
Using research from business, psychology, sociology and neuroscience, brothers Chip and Dan Heath have written a book called Switch: How to change things when change is hard.
This is a “how to” book that begins with a premise:
All change efforts have certain patterns that are similar
- You must start acting differently
- You must change your situation
- You must change how you feel and what you think
- You must get the emotional brain and the thinking brain to integrate
This Fall, ALIGN has teamed up with SoulSalt
coaching to create a program for change. We call our program Ultimate Freedom: Finding your way out of pain. We are seeking individuals who are in pain, and who are ready to move through it! Ultimate Freedom is a 5 week intensive, that is offered in either a group or an individual format.
Utilizing principles of coaching, neuroscience, movement and neuromuscular education, Ultimate Freedom will assist to restore you through a season of change, and a future of no pain!
The health and function within our body depends on many factors: adequate sleep, nutrition, emotional/mental/spiritual wellbeing, and exercise/movement.
In order to get the best health experience with our body, we need to be able to maintain a consistent environment where our cells are given the opportunity to thrive and regenerate. How we move (or don’t move) and use are body on a daily basis plays a big role in the maintenance of our physiological systems: cardiovascular, pulmonary, metabolic, reproductive, digestive and nervous. It can also effect our emotional, mental and spiritual states.
Within the body, the musculoskeletal system is the foundation for our other systems to work efficiently. The skeleton provides the frame for our muscles to attach. The muscles activate and provide the stimulus to pump the oxygen rich blood to all of the body for optimal regeneration of new cells, as well as facilitate waste removal into the lymphatic system.
Consistent practice of alignment principles ensures that the body is in position to allow joints to have full range of motion and muscles are at their appropriate length to stabilize the body and optimize metabolic pathways for daily activities. It also provides a means for you to experience a greater range in your emotional, mental and spiritual sense of fulfillment as you begin to discover where your body is and how you are using it.
Many of our ailments are a result of incorrect use of our body. When the “foundation” starts to shift from baseline, we get increased stress risers or breakdown, which leads to tissue degeneration: arthritis, muscle/ligament tears, muscle strains, organ dysfunction, spinal degeneration, disc herniations.
The more we can pay attention to the objective alignment markers on our body, and be true to our natural design, we can be more vital and pain free! For those of you who would like to know more about the Whole Body Alignment training click here
! For those of you who would like to experience an alignment session click here
! For those of you ready to get started with 10 of the 25 Alignment Points to Optimal Health, see below:
Here is a diagram of the 25 points to Optimal Health created by Katy Bowman, copyright Restorative Exercise™.
Feet facing forward with the outside edges straight. Feet hip width apart.
From a side view the vertical line of gravity should be through the ear lobe, the midpoint of the shoulder, hip, knee and ankle.
Typically the clients that I work with have been in pain for a long time. Pain that has continued past 6 months is considered to be chronic. Most of the people that I see have had pain for years...
As the cycle of pain continues past the normal tissue healing process, pathways to the brain can become affected, this is called central sensitization. A “wind up” of sorts occurs in the nervous system so that your threshold for pain actually lowers. What this means is that, what used to be a mild stimulus sensed in the body, is now more reactive and can set off a “flare”, i.e. a loud noise becomes louder, light becomes brighter.
Studies have shown that exercise can be an effective way to manage chronic pain levels. So, how does someone with chronic pain initiate a program so that it doesn’t set off a “flare” or increase current pain levels?
The goal of a movement or exercise program is to open the “therapeutic window” just wide enough to improve daily function without increasing pain.
The first step is to become aware of performing exercise and movements with good alignment. The better the body is aligned, the less damaging forces are acting on your joints, and your muscles can be more efficient. To learn more about what good alignment
is, attend my free intro to alignment session, and then sign up for Restorative Exercise™ classes.
The exercise classes are designed to move through a variety of stretches and motor skills to get your body back into alignment and functioning more optimally.
The second step is to tune into, and understand your tension patterns. For many people with pain, holding the muscles in a braced and tightened position is very common because it is a way to protect the area. However, over time, the muscles habitually will go into that pattern of tension and you may not even be aware of it anymore. It is important to tune back in and allow the muscles to relax. When muscles are in a constant state of contraction, blood flow is not able to circulate properly to bring in oxygen and remove wastes to the area for tissue healing and regeneration. Learning to become aware of specific muscle groups and to consciously relax them is an essential process to begin to reprogram the nervous system and heal.
Focused breathing can be an effective tool for relaxing muscles. People with chronic pain typically take short, shallow breaths that result in the upper chest and shoulders expanding on the in breath. The goal is to allow the belly to be soft, as you expand the ribcage so the lungs can fill more completely on inhalation. Filling the lungs means more oxygen to your system.
Practice focused breathing and relaxation daily. Start with short sessions, and then progress to 15-30 minutes.
The third step is flexibility. Begin to stretch the muscles that have been held in a contracted state. As the muscles begin to lengthen, the grip and compression held in the joints that they cross, will begin to loosen up. The joints will have more range of motion as the muscles let go. As you stretch, begin to feel for the very first resistance to the motion. In the beginning, it is important to stay below a pain threshold or intense sensation of the muscle being stretched. Make sure that you have good alignment when performing the stretch and stay relaxed. Less is more when you first start out. If you notice that your pain has increased after the stretch session, modify for the next session: 1) you may need to perform every other day rather than daily 2) hold the stretch for less time 3) back off of the intensity of the stretch and make sure you are performing the stretch correctly.
The fourth step is to begin a walking program for endurance and aerobic conditioning. Begin with short bouts of walking, maybe 5 minutes 2-3 times a day. Increase the duration of walk by 5 minutes every 1-2 wks until you are able to walk 20-30 minutes.
Chronic pain conditions require tailored exercise and movement modification. For those of you with chronic pain, utilizing the guidelines presented in this post, may open the “therapeutic window” to enhance function and quality of life.