Vulvodynia
WHAT IS VULVODYNIA?
Vulvodynia is pain in the vulva with no obvious skin or nerve problem and no infection. The vulva is the skin outside the vagina that includes the opening to the vagina, the labia (inner and outer lips), the clitoris, opening to the bladder (urethra), and the mons pubis. This pain can last anywhere from three months to several years. Sometimes it stops by itself. Vulvodynia cannot be passed onto a partner and is not related to cancer.
WHAT ARE THE SYMPTOMS OF VULVODYNIA?
Vulvodynia feels like burning, stinging, aching, and soreness of the vulva (itching is not usually a sign of the disease). This pain can be non-stop, or it can happen when touched (e.g., sexual intercourse, foreplay, or tampon use). The feeling of pain can vary from slightly uncomfortable to severe and this can prevent sitting down comfortably or disturb sleep. Women with vulvodynia can have good days and bad days.
WHAT CAUSES VULVODYNIA?
The experts think that there may be several causes. These include the nerve endings in the vulva being super sensitive to pain and/or overactive pelvic muscles. Although vulvodynia can cause much emotional distress, there is no evidence that it is mostly a psychological condition. Generally your primary care provider will not be able to see any visible reason for it and any tests for infection or other conditions will be normal. It is important to understand that this doesn’t mean that nothing is wrong.
HOW IS VULVODYNIA TREATED?
Overly sensitive nerve fibres are best managed with treatments that can change the way your body reacts to the pain. Please note that usual pain killers and narcotics do not help with your vulvodynia symptoms.
• Local anesthetic gel, lidocaine gel, or cream (5%) might help with symptoms and during sexual intercourse.
• Physiotherapy may help with spasms of the muscles of the thigh and other muscles in that region.
• Devices (such as a pillow shaped like a doughnut) may be helpful to make sitting more comfortable, so that you are not sitting on the painful area.
• Acupuncture, especially when the pain is constant, may relieve your symptoms by helping to “switch off” overactive pain nerve fibres.
• Psychological therapies can help improve coping. Sexual, individual or relationship counselling may also help.
• Overall, although medication has a limited role to play, your care provider may discuss options with you.
USEFUL SITES FOR INFORMATION:
2) www.britishpainsociety.org/patient_publications
3) www.mvprogram.org
4) www.nva.org
