Cotton test -- does this hurt all of you?

I finally saw my gynecologist today, and I told her all about my symptoms and why I thought I had vulvodynia. She agreed that it sounded very much like this is what I have, but she wanted to examine me using a cotton swab. I told her that I had read about that online and tried it on myself already, with lots of pain, but that she was wlecome to do it herself.

The thing is, it didn't hurt me this time. When I tried it myself, my hymen was still intact, and I pressed it along the skin where the hymen met with my vaginal walls. This hurt a lot. It burned, and felt like my skin was ripping. And even after I stopped, it continued to feel scratchy and sore for about ten minutes. This is the feeling I experience every time I try to use a tampon, even the tiniest ones, which is why it's impossible for me to insert them.

Today she pressed it around the skin outside of my vagina and it didn't hurt at all. However, she inserted it at one point, and that was very painful. Which confuses me. She told me that when you have vulvodynia, the skin that she touched would hurt. But it didn't. In my case, the burning pain and the sensitivity seem to be just past the entrance as opposed to outside the vagina.

So I was wondering, do ALL vulvodynia sufferers have this sensitivity to cotton in the same place? Everything about my case screams vulvodynia, appart from this cotton thing. The only difference between me and the average vulvodynia sufferer, it would seem, is that my pain is not slighlty further in. And I was wondering if there are others who have experienced this? Can you have vulvodynia and not feel pain with a cotton swab? Or is this perhaps some other kind of pain disorder?

I got what I wanted out of this visit-- the lidocaine cream. But if this cream doesn't work, she is reluctant to give me medication or other vulvodynia treatments because she's not convinced I have vulvodynia. Which is so frustrating because I'm convinced this is what I have. I think she still thinks I just have a lack of muscle control and am constantly tense. But I keep telling her that it's only because I'm nervous when I go to appointments and that I don't have problems when I'm relaxed at home. I wish medical professionals were not just all about the visible signs, and were more open to listening to the feelings and opinions of their patients. I'm sick of being told I just need to relax.

I've tried the cotton swab test twice, first time it had no effect, second time it hurt, think it just depends on whether it's a good or bad day for me.

Generalised unprovoked V does not respond to Q tip testing and has no visible signs. Did she mention this? I have this and have constant burning pain in various places. Mostly at the 10 oclock position but it gets around. V usually falls under 2 umbrellas, the second is localised provoked which is pain on contact. Umm and some people have a combination of both. Does that make sense?

The only time Ive had this test was at the hands of the first gyno I was referred to. She asked me where it hurt and I tried very hard to remain composed when she scraped my skin and told her where the pain was the worst. She said, 'well, I think everyones a little sensitive there' and suggested I take some more over the counter thrush treatments just in case. Im assuming her degree came out of a cereal packet.

Hahhaaaa Lisa she wouldn't be the only one with that cereal box degree. The gyny who pissed my pudendal nerve off in the first place had never seen vulvodynia before.... and only knew it was vulvodynia when I Dr googled it and sent her the research. All it took was the ability to read! The sub specialist who said the words out loud unprompted said if I was Q tip sensitive she would be scraping me off the ceiling.

Mouse wrote:Generalised unprovoked V does not respond to Q tip testing and has no visible signs. Did she mention this? I have this and have constant burning pain in various places. Mostly at the 10 oclock position but it gets around. V usually falls under 2 umbrellas, the second is localised provoked which is pain on contact. Umm and some people have a combination of both. Does that make sense?

That's interesting. She told me about provoked and unprovoked, but didn't mention anything about the q-tip causing different results with each. She just seemed to write off vulvodynia altogether when the q-tip didn't hurt me, even though it burned like hell when she actually inserted it.

I have pain when sitting, when wearing tight clothing, and on contact. I don't have any spontaneous burning. However I often feel an intense ache when I'm standing up for too long, which I guess is unprovoked. I'm so confused. I wish I could see a specialist.

Well I've got generalised unprovoked V and VVS and I found this test painful on all areas where the tip touched, I think it depends on how sensitive you are and if they hit the right spot. Some women have only a couple of tiny areas that will respond to this test but are causing widespread burning so if they don't hit the exact spot that could be why it wasn't painful. With VVS it's easy to get the right areas because they're red and inflamed but for women who have nothing to see not so easy.

Hey there, I also have pain when sitting which I why I triggered my sciatic nerve. Overcompensating! And I have pain with tight clothing and from standing for too long which can be awkward when I'm cooking.

Is there anyone else you can see.? Alternately find some good research and send it to the Doc you already have. I did that. It didn't do any good but I did find a specialist who knew what she was talking about. I just assume now they don't know everything... or some of them nothing at all. Most vulvodynia websites give a fairly good description of the two conditions. The terms are fairly broad but it's clear that there's not a lot to see in either condition.... generally!

VVS often has red areas in the vestibule, I have red inflamed areas and I know alot of the women from the vulvar vestibulitis website also have redness. General V often has nothing to see but can sometimes. I don't know why some women have visible signs and others don't, mine is odd in that it's actually in two very red distinct lines like I've been scratched and then one side of the vestibule pressed against the other so it's perfectly symmetrical. Nobody seems to be able to explain why this is either.

My cotton test did not hurt....however the doctor said that with unprovoked vulvodynia even a mere cotton test that usually indicates something wouldnt apply to my case. I hurt randomly and the sensations vary too.


So maybe on a better day the cotton swab wouldnt hurt.

I think you must remember that Vulvodynia is merely a name for Vulva Pain....that's all it means. I don't really think it is a diagnosis at all. I have constant unprovoked pain and it worsens with touch, tight clothing, q tip test. That test is an over glorified test anyway...It just confirms you have pain there.

go and see a womens health physio. Gyenocologists, it seems for the most part, are a waste of time. I have yet to talk to any one that has found lidocane helpful. I think you need to address the muscles and trigger points once the yeast or bacterial infeciton has been ruled out.

Hope this helps.

Hear hear, I don't consider it a diagnosis either. My GP looked aghast when I handed her my letter from the vulvar "specialist" and it said vulvodynia, she then said "well that doesn't tell us anything at all except what we already know, you have pain in the vulva". I could have kissed her for being the first Dr I'd seen who agreed with me that it wasn't a proper diagnosis!

I compleately agree. If you went to the doc with a pain in your knee would they say...you have kneeodynia? no, they would find the cause. Why can't they find this cause....

Today I feel as though I am going around in circles. My physio says there must be something triggering those muscles to spazm. But what?! it all started with yeast, maybe that is the problem for me. The whole red yeast theory? My vulva gets red 2 weeks before my period, which could explain that theory as yeast infections get worse around that time, then the rawness comes then during my period rawness and deep ache and bladder symptoms. After period I am almost symptom free for about 5 days then the whole thing starts again, and, I am on the pill. Bloody hormones!!

I agree, vulvodynia is just another catch-all term. IBS is another one.

I don't mind if they want to use these labels for the symptoms WHILE they search for a possible cause. But unfortunately, except for maybe ruling out cancer, too many in the medical profession are over- eager to use these terms and quickly consider it a final 'diagnosis'- therefore their job is done when in reality, their job should just be beginning! In fact, the first doctor I saw for my excruciating pelvic pain/spasms and diarrhea (which I now think was/is more likely Proctalgia Fugax) didn't even come into the room- he just stood in the hallway with an amused look on his face and said I had IBS and to eat a bland diet! I always wonder if non-diagnositic terms such as these come in handy for insurance purposes with the intent to save money (in countries where health insurance is the norm). But then the opposite could be true too- clinics can keep patients coming back over and over again- job security! Or it can be an ego-booster for an unmotivated doctor who tells themselves that they've made a diagnosis and therefore did their job.

No matter how much doctors argue that these vague terms constitute a diagnosis, I will never accept it. To me the definition of a TRUE diagnosis is only where the cause is found, subsequently treated and relief is obtained or in cases where the cause is found but there is no cure then appropriate medication (like for pain relief- and NOT just anti-depressants but regular pain relief) is prescribed. Period.

But I think the sad fact is that the medical profession's primary concern is about people actually dying while caring very little about quality of life. I've read more than once that especially when it comes to pain issues, medicine admittedly comes up very short.

Thank you all for your responses.

How do you think I should approach this? My gyn told me that other than lidocaine, she is reluctant to give me any treatment because of my not passing the cotton test. She is not convinced I have vulvodynia (or whatever you want to call it), but I AM CERTAIN. How do I get her to listen to me? Do you think I should print out some info from the internet and make notes about every symptom I have and every time I feel pain? Perhaps if I really outlined it in a detailed and specific way, she would be more likely to believe me? I know she's a professional, but that doesn't mean she's infallible. How can I convince her that this is what I have, and that other treatments are necessary? Because so far this lidocaine is pretty useless.

GET A SECOND OPINION !!!!! OR A THIRD OR FOURTH!!!

ASAP!

I can't, I don't think that's possible within my city. There's only one hospital, with only one sexual health clinic, and the gynecologist I was sent to is not one I chose, I was just referred to her. I don't know how I would even go about seeing someone else. And there certainly aren't any specialists in the area.

Instead of a gyno see a Pain Specialist!!!

I was diagnosed with neuropathic pain. Which is typically NOT a gyno issue!!

Do whatever it takes to get better.

Hey hon,

I have a rule of thumb with Drs, assume they don't know everything! I mean how could they? I am to this day gobsmacked that my gyny didn't know what vulvodynia was - I agree it's not a diagnosis! I sent her research but went somewhere else. Do whatever it takes. I think we need to be responsbile for own health and road to recovery. It's in our best interests to be researching, finding answers and spreading the word. I have coeliac disease and my GP tells me I know more about it than she does. I live with it every day. I know what the bone pain from vit D deficiency feels like, I didn't just read about it in a book. It's staggering that information that we can find so easily evades all of those bright sparks. Print it off!!! Be well xx.