His and Her Health

Dear members of this board,

By far the largest number of post are about hymenectomy and imperforate hymen. I find this very frustrating because I KNOW that almost always this is an incorrect diagnosis made by a doctor who just doesn't know anything about sexual pain disorders. So I am going to propose that you act like a doctor and make you own diagnosis.

So I have one little test that I want all of you to do:

1) lie down in bed with a mirror in one hand and a wet q-tip in your other.

2) separate the labia majora (large lips) and you will see the labia minora (small lips). The labia minora may be quite large or almost absent as there is a very wide range of normal. Separate the labia minora with two fingers and gently touch all around the opening of the vagina on the outside of the hymen (the vestibule) with the Q-tip. Does it hurt? Is it uncomfortable? IF you answered yes, then YOU DO NOT have an imperforate hymen but you have vulvar vestibulitis. An imperforate hymen does not hurt!

I decided to give this a try.

The hymen and the very entrance does not hurt, but around it as you described does. I did it 3 times just to be sure it wasn't my imagination/coldness from the q-tip. I put very little pressure, enough maybe to put a bandaid on your hand. It was painful enough that I'd rather never do it again, but not so much that I couldn't bear it. It was extremely uncomfortable.

I have a question though, the obgyn I'm seeing currently has the belief that I'm perfectly normal and seems to only be doing the VVS test (coloscopy?) to placate me. She says she has diagnosed women with this before but ALL of them have been so severe that they can't even wear jeans.

Basically I'm confused because MOST literature I've read says that it comes in all forms of severity. If she is truly well versed on this subject why would she dismiss me?

What do I do next if she performs the test and she says I don't have VVS? Get a second opinion?

Yes, VV can cause severe pain or less pain. In my experience, Drs. dismiss us b/c they don't know what to do for us. In my experience, there are very few Drs. who know what Vulvodynia is, let alone how to treat it. You should definitely look for a different Dr. Hopefully, you can find a vulvar pain specialist. I'm in Caliornia too. What area do you live in? Sue

I agree with Sue. VVS doesn't "look" like anything, even on colposcopy. The vestibule should not be tender to touch with a Q-tip. An imperforate hymen is not painful to touch witha Q-tip.

I thought the colposcopy could see the swollen glands around the vestibule? This is what she pointed out in a small diagram she drew. So just because she can't see anything, doesn't mean I don't have it?

I have no idea how to convince my mom to help me get a second opinion, she already BARELY believes me.

How would she know during a Q-tip test that I wouldn't just lie and say it hurts? I seem to give the impression that I'm a liar to doctors =|, or at least someone who exaggerates.

I live in San Diego county, sadly I have Kaiser, which sucks. She is an OBGYN who seems experienced, and again, has diagnosed women before.

I'm just sitting here wondering why the heck I have to go through a colposcopy if it can't even diagnose VVS 100%. Just being in the office makes me want to run out screaming.

Thank you guys sooo much for responding, I have insomnia induced by PTSD. The only thing that keeps me sane some nights is reading this message board.

Reading up on the colposcopy, I'm terrified now, she never mentioned she'd need to use a speculum again or need a biopsy. I guess it's something I'll have to ask about when she calls.

Question: If it DOESN'T hurt to touch the area with a Q-tip (or anything else for that matter), does that mean a person DOESN'T have vulvar vestibulitis? In other words, is it possible to have VV and ONLY have pain when the vaginal opening is stretched beyond a certian diameter, but NOT when it is simply touched?

To Nocture:

A biopsy should not be taken to diagnose VVS, the glands do not look swollen with colposcopy, just red.

To happy at home:
If the vestibule isn't tender to touch then it isn't VVS.

So, the glands are red 100% of all VVS cases?

My vestibule was red and it varied daily. Watch it over time, not just once. Some days it was beet red. Others, slightly more pink than the surrounding tissues. Don't know why?

redness is variable. It really doesn't matter, If the vestibule is tender to touch then you have one form of vestibulitis. please see my article on OURGYN.com that discusses the dozen different causes of vestibulitis.
http://www.ourgyn.com/content/index.php?option=com_content&task=view&id=18&Itemid=66
http://www.ourgyn.com/article_retrieve.php?articleid=209

<small>[ 08-01-2007, 07:28 PM: Message edited by: Moderator ]</small>

I'm sorry Dr. Goldstein, was that an answer to my question or natalieann's?

Both our questions involve redness.

My question was, are 100% of all VVS cases presented with the red glands? Meaning, can my doctor diagnose me with VVS JUST by viewing them via colpscopy?

Nocturne,
As far as I know, you do not need a colpscopy to diagnose VVS. It is diagnosed using the Q-tip test. A q-tip is gently used around your vestibule. VVS patients experience pain just with the touch of this q-tip. I had 2 different docs tell me that redness is one of the other criteria in addition to pain at the vestibule. That's why I said watch for the redness. For me, I have the varying redness The "don't know why" was not really a question. I was just trying to explain to you that every "body" is different and within that, your body is different on different days. You might see redness surrounding your hole at the vestibule. Redness varies so don't just look down there one time. Get to know yourself. Look down there everyday and become familiar with colors/changes. I think that's why Dr. Goldstein said that the redness factor doesn't matter as much, because it DOES vary. Don't worry about percentages/100% is it red or not. What matters is, does it hurt to touch your vestibule with a q-tip. Hope that helps!

Sadly, it doesn't help.

I'm confused because my doctor explained to me that the redness of the glands viewed by a colpscopy is always present in all VVS cases.

She says I don't have VVS, and dismissed my pain during the q-tip test, which she didn't even tell me she was going to do.

It hurt pretty badly even though I was numb, but I wasn't sure how bad it had to hurt for me to say something. She went really fast, I don't feel like I had enough time to tell her how it felt.

Please help me, I'm so confused and distraught.

Dr. Goldstein. My first doctor diagnosed me with VVS and the second (I moved) has ordered a hymenectomy. Touching with a Q-tip does not hurt on the outside, but it does hurt on the inside at 5 and 7 o'clock. Can this still be VVS? It is not stretching the hymen that is painful (although that hurts too), it is just from lightly touching, but it's only on the inside. VVS or hymen?

lillput, have you read all the posts above your last one.Dr. Goldstein has described how to tell the difference between VVS and the hymen.