By Board Certified Urologist Dr. Yana Barbalat
Vulvadynia is a chronic pain disorder, localized to the opening of the vagina and the vulva. Women who have vulvodynia often complain of pain with sexual intercourse and tampon insertion. Some symptoms of vulvodynia can overlap with those of a typical UTI, such as vaginal burning, vaginal pressure, frequency, and urgency to urinate.
Vulvadynia is actually a term that captures many different conditions that can cause pain “down there”. Some women have vulvodynia because there is a lack of estrogen and testosterone in the opening of the vagina, which can be caused by menopause or prolonged use of birth control pills. Other women can have skin conditions and scar tissue that can cause pain in the vulva. Finally, women can experience vulvodynia because they have pain and spasms in the muscles that surround the vagina. This is where UTIs come in once again. Very often, UTIs cause intense urethral pain which makes a patient contract their vaginal muscles while peeing. If this happens often enough, people can develop muscle soreness in the vagina even without an infection. This can cause vaginal pain, vulvar pain, lower abdominal pain, and pain with intercourse.
Although more research needs to be done, there is also a common theory that some women develop vulvodynia because they have an increase in the number of pain receptors in the vulva and vagina.
Now, why would there be an increase in the number of pain receptors in the vulva and vagina?
This is again where UTIs come in. Any trauma or pain to the genitals can cause an upregulation aka “increase” in the amount of pain receptors in the vulva. UTIs, as well as yeast infections and bacterial vaginosis (common after antibiotic use), are painful and can cause the vulva to become more sensitive to any touch/pressure/pain. With repeated infections and cycles of pain, some women may develop vulvodynia and have pain even when there is no obvious infection or cause.
In summary, although urinary tract infections and vulvodynia are very different entities, there is a thought that recurrent UTIs may actually contribute to the development of vulvodynia, as well as present with similar symptoms.