Vestibulodynia & Pelvic Therapy

In an excerpt from a conversation with The Pelvic Rehab Report, Tara Sullivan discusses her course, Sexual Medicine in Pelvic Rehab. She imparts, "As rehab professionals, we are in a unique position to bridge the gap between disciplines with our extensive time for exams and differential diagnoses. Many causes of dyspareunia, vestibulodynia, and IC-type symptoms can be diagnosed by careful observation and testing of the vestibule. This is often the missing link in resolving the patient's symptoms of burning, itching, urgency, and pain."

Sexual Medicine in Pelvic Rehab covers lecture topics that are often taboo in Western cultures, such as hymen myths, female squirting, G-spot, sexual response cycles, hormone influence on sexual function, anatomy and physiology of pelvic floor muscles in sexual arousal, and orgasm. She also discusses vaginismus, dyspareunia, erectile dysfunction, hard flaccid, prostatitis, and post-prostatectomy issues.

So what is Vestibulodynia? Vestibulodynia is a localized form of vulvodynia. The Baylor College of Medicine defines vestibulodynia as "chronic pain or discomfort that occurs in the area around the opening of the vagina, inside the inner lips of the vulva. This area is known as the vestibule."

Tara Sullivan shares, "The vestibule is considered the forgotten organ. Most disciplines completely bypass it in their exams." So how is vestibulodynia treated, especially if there are no visible symptoms? The patient should discuss their symptoms with their primary practitioner to rule out medical issues such as yeast infection or cancer. Pelvic specialists can perform a physical pelvic exam, with patient consent, to examine the vestibule, vulva, and vagina. A cotton swab touch test can also be used to pinpoint areas of sensitivity.

The treatment strategies for vestibulodynia focus on relieving the pain and discomfort of the patient. These strategies include lifestyle changes (looser clothing, changing personal routines), including the use of lubrication or local anesthetic creams for intercourse, and therapy or sexual counseling. Vestibulodynia patients can be referred to a pelvic rehab therapist to learn how to relax the affected muscles and control painful spasms. This therapy can include the use of diaphragmatic breathing, biofeedback, pelvic wands, or pelvic dilators.

Vestibulodynia is only one of the topics that Tara Sullivan discusses in her course, Sexual Medicine in Pelvic Rehab. Participants will learn how to confidently treat sexual dysfunction related to the pelvic floor, refer to medical providers as needed, and instruct patients in the proper application of self-treatment and diet/lifestyle modifications. 100% of participants surveyed in the last class answered YES to "Do you feel this course instructed immediately-applicable knowledge and skills that could be used in the clinic with patients?"

Sexual Medicine in Pelvic Rehab is scheduled for 2022 on January 8-9, April 9-10, July 16-17, and October 15-16.