Vulvodynia and Sexual Pain

Women with vaginismus may see eight or nine gynecologists before receiving effective treatment, indicating a significant gap in specialist knowledge. High-oxalate foods such as raw spinach and kale may worsen vulvar pain in susceptible individuals, particularly those also dealing with candida. Vaginismus is an involuntary contraction of the vaginal opening muscles that can make penetration painful or impossible. Vestibulodynia involves pain in the vestibule, which contains estrogen and testosterone receptors, meaning hormonal deficiency can directly contribute to the pain. Non-food irritants such as detergents, soaps, and topical products can cause or worsen vulvar and urethral symptoms, and tracking exposures is a recommended clinical step. Botox can treat vaginismus by reducing involuntary muscle firing, enabling women who could not previously have penetrative sex to do so.