Diagnosis

Diagnosis requires a combination of a medical consultation and a gynecological examination with smears of the intimate region. During the conversation, special attention is paid to current complaints. Bartholinitis is usually a diagnosis of the gaze, as the symptoms are very typical.

Inflammations of the intimate region are diagnosed by means of a smear. Here, we look above all at which pathogen is causing the symptoms. Benign and malignant changes can be detected by taking a sample of the changed region and then examining it under the microscope.

Varicose veins and vaginal dryness are also eye diagnoses. In order to rule out an estrogen deficiency, blood must be taken and the hormone level checked. Vulvodynia is a diagnosis of exclusion after gynaecological, dermatological, neurological and, if necessary, orthopaedic examination to find no cause.

Accompanying symptoms for pain at the vaginal entrance

Just like the causes, the accompanying symptoms can also vary. In the case of bartholinitis, an abscess can lead to other general signs of inflammation such as redness and warming of the skin. Inflammation in the vaginal area often causes unspecific itching, burning, redness, pain when urinating and/or sexual intercourse and, if necessary, changes in vaginal discharge.

The lymph nodes in the groin region may also be enlarged. Depending on the pathogen, typical symptoms such as whitish deposits in a fungal infection or blisters in a herpes virus infection may also occur. Benign changes can lead to skin changes such as whitish, shiny skin and reddening of the skin, itching, burning sensation, wetness, warts and discomfort during sexual intercourse.

Malignant changes may cause itching long before visible changes occur. Burning and swelling can also occur. Dark skin changes and whitish mucous membrane are another sign of malignant changes. A dry and irritated vagina is also noticeable by itching, burning and problems during intercourse. Varicose veins are also often accompanied by itching.

Therapy for pain at the vaginal entrance

Irritation of the vagina by aggressive care products can be prevented by using milder care products or only lukewarm water for cleaning. The therapy of choice for bartholinitis is a so-called marsupialization. In this procedure, a small incision is made in the swelling, the edges of the Bartholin glands are turned outwards and sutured to the labia.

If an abscess is present, the pus is drained and tested for pathogens if necessary. In the case of inflammation in the vaginal area, the therapy depends on the pathogen in question. For herpes infections, antivirals such as Aciclovir are used locally or, in severe cases, in tablet form.

Fungal infections are treated with antimycotics such as Clotrimazol. For bacterial inflammations, antibiotics such as metronidazole in tablet or ointment form are used. If necessary, the sexual partner must also be treated if sexually transmitted diseases are involved.

Depending on the nature of the benign changes, corticosteroid creams can be used symptomatically. Warts are first treated with the antiviral drug Imiquimod and then removed with CO2 laser, cold therapy (cryotherapy) or a sling. In the treatment of malignant changes, the therapy depends on the stage.

In the case of preliminary stages, removal is carried out by laser or surgery. In the case of carcinomas, these are cut out as far as possible and, depending on the location of the tumor, radio- or chemotherapy is used. In the case of vaginal dryness due to estrogen deficiency, creams, suppositories or gels that are applied locally are usually helpful.

In more severe cases, for example during menopause, when other symptoms occur, hormone therapy with progestin estrogen preparations can be used. No causal therapy exists yet for the treatment of vulvodynia.Creams with estrogens or narcotics can be applied locally and painkillers for chronic pain can be taken. Biofeedback of the pelvic floor and neuromodulation are also used in these cases. Varicose veins in pregnancy usually disappear or improve on their own after birth. Cooling or padding sanitary napkins can be helpful to relieve the current symptoms.