Steps to Addressing Persistent Genital Pain.

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Where do you start, and what do you do if you have genital pain? More specifically, what do you do if you have persistent pain that won’t go away in your vulva, and/or vagina?

Here is a simple list of some actions you should take to start addressing the issue, as well as things you can do without the guidance of a doctor to try to rule out potential causes, and/or to lessen irritants once diagnosed. This is not an exhaustive list, but it’s a great place to start!

  1. Visit your obgyn and have them do an inspection of your vulva/vagina, get tested for infections, and make sure perimenopause/menopause are taken into consideration if applicable.
  2. If all looks good (no signs, or symptoms of lichen sclerosus, vulvar cancer, vaginal atrophy etc) and tests are negative for infection, then proceed with an evaluation for vulvodynia/vestibulodynia usually done via the q tip method. If your obgyn is not well versed in vulval-vaginal conditions consider finding an obgyn who is, or get a referral to a pelvic physical therapist CERTIFIED IN WOMENS HEALTH to evaluate you for the different forms of vulvodynia, AND any possible pelvic floor issues (PFD, vaginismus etc.). **The mention of vulvar cancer is not to scare, simply to be made aware that cancer of the vulva does exist, and can be caught early with attention to symptoms. Also of note is that many obgyn’s in fact are not well versed in vulval-vaginal/pelvic floor conditions so it is not uncommon to need to seek out someone with more expertise for persistent genital pain not caused by infection.
  3. (Start doing the rest of these steps while doing the first two) Check your menstrual products for harsh chemicals, and perfumes. If you’re currently using menstrual products with harsh chemicals and fragrances then switch to organic cotton pads, tampons,  reusable menstrual cup, or reusable cloth pads. Why? To rule out irritation being produced from your period products.
  4. Stop washing your vulva with soap. The vulva and vagina are self cleaning and should only ever be cleansed with clean water (simple google search will show you the facts to back this up). Furthermore, stop washing with fragranced soap all together, and transition to unscented soap without harsh chemicals, and see if you notice a difference in pain.
  5. Wash your clothes in unscented hypoallergenic detergent, or at the very least wash all of your underwear/pants with unscented detergent. Your vulva comes into contact with your underwear every day, so if your detergent contains something irritating to the tissues, such as fragrance, it’s going to be steeped in it for hours. Forgo wearing any thongs or tight fitting underwear.
  6. Try wearing looser fitting clothes such as looser jeans, or no jeans at all. Give your vulva some room to breathe!
  7. If you are sexually active take a look at the condoms you are using and any lubricants. You want to make sure that your lubricant is fragrance/flavour free, free of harsh chemicals, and typically water based. In regard to condoms, it’s better to go with ones that are NOT pre-lubricated, and that do not contain spermicide so that you can choose your lubrication without potential irritants. It’s important to forgo any sensation producing condoms such as “fire and ice” to avoid any irritation from the compounds used to produce those sensations. If you think latex may be an issue please research and purchase latex free condoms.

Again, this is not an exhaustive list, but it is generally what you do to start trying to get a proper diagnosis/locate the issue, as well as to rule out contributing factors. Take control of your life and get to the bottom of your genital pain! XO


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