Vulvodynia

[EdithGrantham]

I've suffered from pain in my vagina during sex and sometimes when putting tampons in since I was 19 when I had a bad bout of thrush. I've been back to the doctor's a few times about it to have it dismissed as vaginal dryness.
I'm now 34 and expecting my first child. I thought I might struggle with any internal exams during childbirth so have been doing some googling and the above condition came up, specifically vestibulodynia. I rang my doctor today to have an appointment to discuss this and if there's anything that can be done to mitigate potential pain during internal exams.
I'm fully prepared, as much as you can be, that labour is going to be another level of pain but thought if I can avoid any "unnecessary" pain that might be helpful. He was pretty dismissive, lumped the conditions in with vaginismus (which I don't think is the primary cause of my pain) and "reassured" me by saying "I think you'll be fine, at that point in labour you won't care if someone needs to out their whole hand in you and you do need to be prepared for the fact that labour and childbirth are possibly the worst pains you'll ever experience" he did offer to see me in person to do an internal exam but with his attitude so far I declined. He also suggested I speak to my midwife and she might refer me to the obstetrician who will have more experience.
I came off the phone and cried because I feel like I've been putting up with this for my whole adult life and have now essentially been told to lump it during childbirth as well (to doubly clarify as the Dr didn't seem to understand this, I do get that labour and childbirth isn't going to be a pleasant pain-free experience!).
I will of course speak to my midwife and hopefully be seen by someone with a bit more experience of this issue but in the meantime any kind words or sympathy would mean a lot to me right now.

Hi, I have a similar situation and as far as I can tell it has been bought on by a doctor saying exactly what one said to you just before they examined me in labour. It makes me so cross that when you are at your most vulnerable doctors/midwifes make flippant comments that can impact the rest of your life. For any future pregnancies I will be under the perinatal mental health midwife team- and am having an elective c section.
Might be worth contacting your local hospital to see if they have anyone who can discuss this with you? Or even your midwife maybe able to assist or direct you to someone who can offer the support you need?
I hope you find a more sympathetic ear soon

Thanks so much, glad to know I'm not alone but sorry to hear you've had similar. I'll definitely talk to my midwife about it at my next appointment, wish I hadn't bothered with the doctor at all, he kept on about his wife's birth as if that is the same as being experienced in women's health during labour and birth

Nope, nope and nope. I really hate this dismissive attitude.

I found internal exams very painful during Labour. I really resent the idea that our prior concerns are so dismissed.

I ended up with 3 sections. One anaesthetist 'joked' that I was too posh to push, with my second, and my third was a total farce.

Sadly women are considered hysterical in many birthing situations and even midwife-driven births can be the luck of the draw in terms of supportive care. Absolutely stand your ground and be a bit 'difficult' if you need to be. (I don't mean be stroppy, more assertive about your concerns)

I know they're the medical experts, but that doesn't mean they get to discount your concerns.

Sadly maternity and obstetric care seems very dismissive of the women they're supposed to serve, in the uk.

Best of luck op

Thanks Candy, I feel like I wasted my time because I've been brushed off so many times with this by male and female doctors that I'd about given up. I wrote bullet points down because I knew what I wanted to say and get across and still came off the phone feeling like shit. I did say to him that what he was saying doesn't match my experience and that's when he offered an internal exam but by that point the trust was gone. Hoping the midwife will be more sympathetic.

he kept on about his wife's birth as if that is the same as being experienced in women's health during labour and birth

Well I'd be inclined to tartly remind him, that you are not his wife, and neither is he so he's not in a position to comment on either of your pain thresholds so perhaps he might like to politely wind his neck in and stop mansplaining long enough to listen!

Congratulations on your pregnancy.

Check out the Vulval Pain Society, they have lots of helpful information on their website and links to support groups etc
www.vulvalpainsociety.org/vps/

Vulvodynia is treatable, you would need to see a gynaecologist with knowledge/experience of the condition (not all have it, sadly!) and for many people, special women's health Physiotherapy is very helpful too.

I had vulvodynia for years, it was much improved after women's health Physio, I got pregnant without issues and I had a vaginal birth, then once I'd fully healed from the birth the vulvodynia had gone.

So it is possible to get treatment and have a vaginal birth if you want. (You can also decline vaginal examinations, they are far from compulsory!) but if you would prefer an ELCS that is your choice and you have a medical reason for it.

Ask midwife to refer to consultant obstetrician and/or consultant midwife to discuss your options.

I wish I'd thought if something like that to say to him but was so frustrated (to that point where you go all hot and can feel tears gathering) that I just let him carry on
Thanks NameChange, that's the website I came across that lead me to my self-diagnosis, it was a relief to know it is a real condition then to have it misunderstood by a doctor AGAIN was very upsetting. From what I've read it seems like my case of it is relatively mild, the pain is quite localised and I think childbirth itself is likely to be no more painful for me than someone who doesn't have this or similar conditions. It's purely the examinations that I'm worried about and I would really rather avoid a C-section if possible.
I also came across an old thread on here where someone who had been diagnosed with vulvodynia was put down as higher risk because of it and strongly encouraged to either have an ELCS or at least give birth in the ward so they could have an epidural. This kind of puts me off mentioning it to the midwife as I was feeling anxious about medical interventions and really hoping for the birthing centre if all goes well. Did it change your risk factor at all when you were pregnant?

No it didn't, low risk both times. With DC1 I started in the MLU but was transferred to the delivery unit (same building), nothing to do with the vulvodynia. DC2 was born at home.

I was very worried about tearing. I had an episiotomy first time around and it was very sore but all healed fine. Also had a tear second time but it was less sore and again healed fine (much more quickly).

Vaginal examinations are not compulsory, you can decline them (and sweeps as well). See www.aims.org.uk/information/item/vaginal-examinations-in-labour

Thanks, that's really reassuring. Will definitely speak to my midwife about the option not to have routine exams and ask if she's able to refer me to consultant midwife or obstetrician. Feeling much calmer after all the advice on here so thank you again everyone