I have been having pain on my vagina for a long time and have tried all the over the counter medicines for infections I could  find. Nothing is helping and it hurts just to pee and wipe myself. Sometimes the burning is bad just when I sit for too long or wear jeans.  I can’t even think about being sexual and my boyfriend thinks I am making it up and it is all in my head because you can’t really see anything, but sometimes it is a little red and swollen.  I don’t know what to do. Any ideas?

What you are describing sounds painfully familiar to many women who, like you, often go without a diagnosis or treatment. Chronic pain on the outside of the vaginal opening, which is called the vulvar region of the vagina, is called vulvodynia. Symptoms include the burning you mentioned, itching, stinging, rawness, soreness and painful intercourse.

For many women the first sign of symptoms comes with first experiences of intercourse, which is one of the reasons that many women don’t talk about it or go for help.

Some women who have struggled with reoccurring bacterial or yeast infections have a higher risk of vulvodynia, while others have a history of sexual abuse.  However, most women with vulvodynia have no known factors that are associated with the condition.

A similar condition called vulvar vestibulitis may cause pain only when pressure is applied to the area surrounding the entrance to your vagina.  Another related condition called vaginismus might also be considered if the muscles around and in the vagina tend to spasm. It is not an easy call, as vaginal pain can cause spasms and spasms can cause pain.

Vaginal pain is a fairly common condition with varied studies putting the percentage of women affected at somewhere between 8 and 15%.  These findings suggest that pain in the vaginal area impact over 2 million women in the US alone.  Although there are still some physicians who are unfamiliar with this condition and treatments, the awareness and range of treatments is growing. If you have chronic or reoccurring genital pain you should find a physician who can help you and rule out easily treatable causes of vulvar pain.

Sometimes basic advice like switching to cotton underwear and giving up tight fitting clothes can make a difference. Avoiding petrochemical irritants in douches, soaps, detergents and lubricants can also make a big difference for some women. Some women have success with the use of topical crèmes and hormones.   Still others have reported eliminating pain through a low-oxalate diet which has helped those women with  high urine oxalate levels. Many women have also found relief through bio-feedback programs, physical therapy and relaxation programs.

Education is a good friend when it comes to conditions that impact our daily life and this condition has both excellent website resources and books to better understand what is happening in your body and take the steps to deal with it effectively.    A visit to the National Vulvodynia Association is an exhaustive site that offers patient resources,  medical professional referrals and online educations. The best advice I can give any woman who is struggling with pain is to not just accept it. Do the research and find the support you need to move towards solutions to your pain. We are always our own best advocates.