Perimenopause and Vaginal/Vulvar Pain

The Common Problem Women are
too Embarrassed to Discuss

Burning, stinging, itching, raw. That is the experience of millions of women, who suffer silently with unexplained vaginal pain. For some, intercourse, tampons, even tight pants are out of the question. During perimenopause, as estrogen levels decrease, blood vessels constrict and circulation is lowered, causing the potential for pain and infection in the vagina.

This is a situation that can destroy relationships. The more it hurts, the less intimate a woman is likely to be. But women don't talk about this subject because of the delicate nature of the problem. In fact, this is a very big problem among perimenopausal women, and I think it is a subject that we must be open about in order to help each other find ways to manage the discomfort ... and to be reassured that it's not "your fault."

It's important to understand that the reduction of estrogen during perimenopause reduces blood circulation, which affects vaginal lubrication. The vaginal skin dries up, and can become itchy and irritated, just like dry skin anywhere on your body.

Less estrogen means vaginal PH increases and the lining of the vagina thins, which, in turn, creates an imbalance in the good bacteria. This imbalance can leave you prone to infection. Furthermore, the urethra and vaginal canal become even closer, due to the thinning wall between them, and increased PH in the urinary tract, creating the opportunity for not only vaginal, but urinary tract infections as well.

In addition, research is proving that the causes of sexual pain are complex and not just located in the genitals. For instance, irritable bowel can trigger sexual pain.

Vulvodynia

The literal definition of vulvodynia is "pain in the vulva." (The vulva is the female genital area.) It isn't an illness, but a symptom, like an earache. This pain usually manifests as burning or stabbing pain throughout the vulva.

Vulvar Vestibulitis

Vulvar vestibulitis is a condition causing very specific pain in areas of the vulvar vestibule (skin around the vaginal opening). Women often experience the irritation and pain anywhere from the middle left side down to the bottom (below the vaginal opening) and up to the middle right side. In addition, women may have the pain around the opening of the vagina. The pain can be very sharp and women may even find bumps, sores, or even small granules that feel like sand just under the skin.

Numerous women experience both vulvodynia and vulvar vestibulitis. In either case, vulvar tissue is painfully dry and can be easily cut. Both cases may also involve "referred pain", in which the pain feels as though it travels from the vulva to the lower body."

Pain, Sores, and Bumps of No Known Origin

Anecdotal evidence indicates that there's a third category of women who have neither clinical vulvodynia or vulvar vestibulitis, but suffer with pain, sores, or bumps throughout the genital area, including the opening of the urethra, experiencing burning after urination. Other women may also experience rectal pain or itching.

Over time, sensitive vaginal tissues can actually change, producing conditions that further aggravate the situation. Another condition that may develop with chronic vaginal pain is vaginismus. This is an involuntary spasm of of pelvic floor muscles, preventing penetration, for example, with tampons or during intercourse. This can be an involuntary protective response to the chronic pain.

Vaginal Infections

As for infections, some common vaginal and urinary infections (non-STD) include:

Strep B—This is a normal bacteria found in the vagina, but can grow out of control under certain circumstances. You will need antibiotics if the overgrowth is too great.

Vaginitis—Non-bacterial discharge from the vagina can cause discomfort. It may itch or burn and vary in consistency and color.

Yeast infection—This is a vaginal infection caused most commonly by the fungal organism,

Candida albicans. You may get a yeast infection after taking antibiotics, which disrupt the normal balance in the vagina by suppressing the growth of protective bacteria that normally have an antifungal effect.

Note: Always see a doctor to determine the type of vaginal infection you have, or if it is a bladder infection, and then treat it!

By the way, there is a strong connection between vaginal pain and fibromyalgia as well as irritable bowel syndrome.

See a Doctor

If you suffer with vaginal pain or chronic infections, see a doctor. There really are ways to help manage these symptoms and reduce the pain.

Note: See a doctor immediately if you experience burning, stinging, itching, pain, or a vaginal discharge. You may have an infection and must take medication to clear it up.

Natural Tips for Relief

Here are a few natural tips to prevent vaginal infections and pain.

• Wear only cotton underwear (preferably white so there are no dyes). They make really cute cotton undies now, that are even sexy.
• NEVER wear underwear to bed—so your body can breathe. Underwear (or tight clothing) restricts airflow to your genital area, often leading to increased temperature and moisture that can cause irritation. No underwear gives that area a chance to dry out.
• Use only water to wash—the vulva needs nothing more than water for cleaning. In fact, soap can really upset the balance of vaginal flora and cause more pain. Use oatmeal soap if you must, which seems to clean but not cause irritation.
• Believe it or not, allergies, including food allergies, can cause symptoms. Try keeping a diary to see if symptoms get worse with eating certain foods.

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