Your vulva hurts. Your vagina hurts. You’ve been told you have vulvodynia.

One doctor says the problem is in your nerves. Another says the problem is in your muscles.

But has anyone checked your connective tissue?

There is no doubt that in most cases of vulvodynia there is a problem with the nerves – either the local nerves of the vulva, or the central nervous system (the nerves that travel through your spinal cord and brain). In fact, some cases of vulvodynia are more accurately termed pudendal neuralgia (a problem with the pudendal nerve, which goes to the vulva).

Equally, most women with vulvodynia have a problem with the pelvic floor muscles – either as a cause (they were tight first, and caused dysfunction) or an effect (sex hurts so much it makes muscles tense up). Sometimes this is called vaginismus – confusing!

But the connective tissue is an often overlooked area that can contribute to vulvodynia as well.

So, what exactly is connective tissue, and what does it have to do with vulvodynia?

Connective tissue is the wrapping that covers your muscles and organs, and separates them from each other. It separates different layers of the body – skin from fat, fat from muscle, muscle from deeper muscle, and organs from muscle. It is everywhere in your body, connecting and holding everything together.

Connective tissue wraps around your blood vessels (veins and arteries), your lymphatic vessels (which carry fluid) and around your nerves. It is even wrapped around individual strands of your nerves, and individual fibres of muscle!

With this connective tissue surrounding and connecting all parts of your anatomy, can you imagine some of the effects if it’s tight or inflexible?

That’s right: pressure, tension, pulling, tugging, squashing and restriction of muscles, nerves and blood vessels. This can lead to pain that feels like burning, tugging, pinching, grabbing, swelling and “something getting stuck”.

Part 2 in this series will help you understand your connective tissue further – including how to get it healthy and flexible.

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