You're well aware it's possible to feel sad, mentally and emotionally, where you could be exhibiting symptoms of depression even. Yet, your vagina? It can actually become depressed, too. While the condition isn't well known and it's often hard to diagnose, it does exist, and you might need to go on antidepressants to give your vagina some relief. Here's how to know your vagina is down in the dumps and in need of a happiness boost.
What's a Depressed Vagina, Really?
The term "depressed" vagina comes from the fact that sometimes we can prescribe antidepressant medications to improve the "health" of the vagina, particularly in a condition called vulvodynia. Vulvodynia means "pain in the vagina," and it affects 4 percent to 16 percent of the female population, explains Dr. Landa, MD, an ob/gyn and chief medical officer of BodyLogicMD of Orlando to POPSUGAR.
Vulvodynia is a frustrating diagnosis for doctors and patients alike, she says. The symptoms typically include pain at the vaginal entrance, and it can be either constant or intermittent or only prevalent when being touched.
What's more, "the pain can be in one spot or multiple different spots but usually around the opening of the vagina. Women can feel itchy, sensitive, and even have severe burning pain, which can make sex downright impossible," she says.
What Causes It?
The cause is really pretty much unknown. There seems to be a link between women who have had a lot of vaginal infections and the development of vulvodynia, she says. "Some vulvodynia is thought to be more related to a more generalised type of pain from nerves that aren't firing properly, similar, in a way, to fibromyalgia. Some suggest that vulvodynia might be associated with oral contraceptive use or other hormonal changes like menopause. It does seem to run in families, so there may also be a genetic component," she says.
Basically, it can be a number of reasons, all of which haven't been agreed upon. However, if the doctor is suspecting this diagnosis, a cotton swab test can be done during the visit.
Unfortunately, it's so hard to diagnose, these symptoms can easily be confused with vaginal infections. "Complicating the issue even more is that many times the vaginal examination of a woman with vulvodynia is completely normal. The very definition of vulvodynia is vulvar pain that has no clear identifiable cause," she explains. That's enough to depress anyone's anatomy.
The bad news is, a depressed vagina can make you mentally depressed, too. "Women do experience shame and guilt and this leads to psychological distress and even total overall depression in some women," she says. "Women with this diagnosis tend to feel very isolated and alone," she adds. Yet, in about one quarter of women who have vulvodynia, it will go away by itself.
How to Treat It
Still, here are a few ways to treat it. "If you suspect you have this problem, the first thing to do is to make sure you're not reacting to anything you're using in your daily life. If you douche, stop immediately. There is no reason to douche. The vagina is a self-cleaning machine and douching only makes any problem you're having worse," she says. Make sure you're using a very mild detergent to wash your underwear or even use water only, and you can try the "free and clear" versions with no dyes or perfumes, she adds. Also, use only cotton panties and don't use panty liners. If you must use them, then buy the ones that are hypoallergenic, she says.
"I've seen many women make their vaginal pain issues worse by overtreating for infections. They keep using medications to treat yeast infections and then topical antibiotics to treat bacterial vaginosis and this can make the problem much worse by causing severe irritation caused by all the chemicals in the treatments," she says. To note, a thick, cheesy discharge with intense itching is usually a yeast infection, while a thin discharge with a really fishy smell will frequently be a bacterial vaginosis infection. If there is no discharge or odour, usually there is no need to treat with an antifungal or antibacterial cream/treatment.
Also, "women should try applying coconut oil to the vulva as it is moisturising and antibacterial and antifungal. Use it as a lubricant for sex (it's my fave lube for women)," she says. You can also try Epsom salts baths or colloidal oatmeal baths to calm irritation. Avoid soap in the area and only wash with water.
You can also try cognitive behavioural therapy, a form of psychotherapy. "That's not to say it's all in your head, but some women have done well with this treatment. Acupuncture has been shown to have some benefits, she says, as well as pelvic floor physical therapy.
"Most women with vulvodynia get treatment with a topical cream or ointment. Popular options include anesthetics like lidocaine or anti-inflammatory medications like cortisone type creams. Sometimes doctors will have compounded creams or ointments made with pain relievers and, yes, antidepressants. Sometimes hormone therapy can be effective as well," she says. Oral medications include antidepressants and pain relievers.
How to Make Your Vagina Happier
First off, you'll want to avoid infections. "To avoid yeast infections that may lead to vulvodynia, eat a low-sugar, low-carb diet because sugar feeds yeast, and consider a probiotic to help reduce yeast by increasing healthier flora, especially lactobacillus rhamnosus. Also never sit around in sweaty gym clothes," she says.
Another step to a happier vagina is using boric acid 600mg suppositories. Many vaginas get "depressed" when the pH (acid/base) balance is off, and usually it is too high. "This increases the likelihood of infections and symptoms. Using boric acid suppositories will treat an infection if they're used for 10 days, but I frequently find patients will have relief of symptoms of itching, burning, and discomfort in just a few days of use," she says.