What is Vulvodynia?
According to the National Vulvodynia Association, vulvodynia is chronic vulvar pain without an identifiable cause. The location, constancy, and severity of the pain vary among sufferers. Some women experience pain in only one area of the vulva, while others experience pain in multiple areas. The most commonly reported symptom is burning, but women’s descriptions of the pain vary. One woman reported her pain felt like “acid being poured on my skin,” while another described it as “constant knife-like pain.”
There are two main subtypes localized and generalized vulvodynia which, sometimes co-exist.
Localized Vulvodynia. Pain at only one vulvar site. If the pain is in the vestibule, the tissue surrounding the vaginal opening.
Generalized Vulvodynia. Pain occurs spontaneously and is relatively constant, but there can be some periods of symptom relief.
How does it feel?
Common descriptions include a burning, stinging, irritation or rawness feeling in the vulva. Vulvodynia can cause the entire area to be painful or just a specific area.
According to Acog.org, some of the causes of vulvodynia include:
- Damage or irritation of the nerves of the vulva
- Inflammation of the vulva
- Long-term reactions to certain infections
- Certain genetic disorders
- Sensitivity to certain foods
- Dysfunction of the muscles of the pelvic floor
- Conditions that affect nearby muscles or bones
Steps to relieve pain
- Wear cotton underwear
- Don’t wear any underwear while you sleep
- Do not douche
- Avoid irritants like perfume and shampoos.
- Clean the area with water
- Use 100% cotton pads
- Don’t use a blow dryer to dry vagina
- Use cool gel packs on the vagina
Aside from obtaining your medical, sexual and surgical history, your OB/GYN Specialist may need to perform the following exams.
Pelvic Exam – You will be visually checked for an infection on your external genitalia and vagina. Even without the visual signs of an infection, your OB/GYN Specialist may sample cells from your vagina to test for a yeast infection or bacterial vaginosis.
Swab – Using a cotton swab, your OB/GYN Specialist will check for a specific area of pain in the vulvar region.
How is it treated?
According to mayoclinic.org, treatments revolve around the symptoms and their relief.
- Medications. Steroids, tricyclic antidepressants or anticonvulsants can help lessen chronic pain. Antihistamines might reduce itching.
- Biofeedback therapy. This therapy can help reduce pain by teaching you how to relax your pelvic muscles and control how your body responds to the symptoms.
- Local anesthetics. Medications, such as lidocaine ointment, can provide temporary symptom relief. Your doctor might recommend applying lidocaine 30 minutes before sexual intercourse to reduce your discomfort. Using lidocaine ointment can cause your partner to have temporary numbness after sexual contact.
- Nerve blocks. Women who have long-standing pain that doesn’t respond to other treatments might benefit from local nerve block injections.
- Pelvic floor therapy. Many women with vulvodynia have tension in the muscles of the pelvic floor, which supports the uterus, bladder, and bowel. Pelvic floor therapy (including kegel exercises) can relax those muscles can help relieve vulvodynia pain.
- Surgery. In cases of localized vulvodynia or vestibulodynia, surgery to remove the affected skin and tissue (vestibulectomy) relieves pain in some women.