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Vaginismus, dyspareunia, vulvodynia, and vestibulodynia

Do any of these words look familiar to you? Maybe you have come across all of them or some of them in your internet searches to better understand symptoms you are experiencing related to pain in the vagina or vulva or painful sex.

Today, I would like to shed light on each of these terms to help you better navigate your symptoms.


This is the term used to describe painful sex. During dyspareunia, pelvic floor muscles do not relax well with desire or arousal. There is also a decrease in the secretion of lubrication. The pain can occur during or after intercourse.


This is when your pelvic floor muscles tense up from fear of penetration. This could cause difficulty with a pelvic exam, tampon use, or sex. There is a psychological component to the pain also that needs to be addressed. This means that if you have had a painful memory or experience with vaginal penetration you must treat the fear component and the physical symptoms.


This is a term used to describe pain in the vulvar region for greater than 3 months. It’s a very general term used to describe the location of pain, without any identifiable causes or associated factors.

Think of this the same way a diagnosis of “shoulder pain” tells you the shoulder is involved, but does not identify which part of the shoulder is the culprit.

The term vulvodynia is an umbrella term which can be broken down into a number of more specific diagnoses such as generalized vulvodynia, localized vulvodynia, spontaneous vulvodynia, vestibulodynia, provoked vestibulodynia, and vulvar syndrome.


This is one form of vulvodynia in which pain is only in the vestibule.

The vestibule surrounds the opening of the vagina and the opening of the urethra.

There are different causes of vestibulodynia. It can be caused by hormones, inflammation, or nerve proliferation (duplicates itself). Thus, treatment varies depending on the cause of your symptoms.

In the diagram below you can see which area of the vulva is the vestibule.

“Permission to use copyright image from Pelvic Guru, LLC”

Putting It All Together

You can have one or more of these diagnoses at the same time. A person can develop overactive pelvic floor muscles that occurs with fear of penetration, pain in the vulva, and pain in the vestibule all at the same time.

You can also have painful intercourse which does not cause pain in the vulva and does not cause pain in the vestibule.

If you are dealing with symptoms of pain in the vagina, pelvic floor, vulva, or vestibule and would like to know what you can do to help, please schedule a Discovery Call with Katy or Miranda at The Fit Pelvis.


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