Vulvodynia

Definition

Vulvodynia is chronic pain or discomfort of the vulva. The vulva includes the:
  • Labia majora and labia minora
  • Clitoris
  • Vaginal opening
Female Genitalia
si55550966 96472 1 vulva.jpeg
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Causes

The cause of vulvodynia is not known. Some possibilities include:
  • Injury or irritation of vulvar nerves
  • Inflammed tissue
  • Abnormal response to infection or trauma

Risk Factors

Vulvodynia is more common in women who are younger. Other factors that increase your chance of developing vulvodynia include:
  • History of vulvodynia
  • Chronic pain or disorders associated with chronic pain
  • Sleep disturbances
  • Some mental health disorders, such as post-traumatic stress disorder
  • Recurrent yeast infections
  • Frequent use of antibiotics
  • Irritation to the genitals by soaps or detergents
  • Genital rashes
  • Previous treatment or surgery to the external genitals
  • Pelvic nerve irritation or muscle spasms

Symptoms

Symptoms may include:
  • Pain, which may come and go
  • Burning
  • Stinging
  • Irritation
  • Rawness

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. It may include a pelvic exam. The affected area may need to be examined closely. This can be done using a colposcope to magnify the area.Your bodily tissues and fluids may need to be tested. This can be done with:
  • Tests to check for bacteria and/or yeast
  • Biopsy

Treatment

Talk with your doctor about the best treatment plan for you. Options include:

Medications

  • Topical medications that are applied to the skin, such as corticosteroids, estrogen, or anesthetics
  • Antidepressants
  • Anticonvulsants
  • Prescription pain relievers

Physical Therapy

Therapy can help you strengthen and relax your pelvic muscles. This will ease muscle spasms. You may be referred to a doctor who specializes in pelvic floor issues.

Other Treatments

Suggested treatments for vulvodynia include:
  • Injections
  • Nerve stimulation or nerve blocks
  • Surgery

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Prevention

There are no current guidelines to prevent vulvodynia.

RESOURCES

The American Congress of Obstetricians and Gynecologists
http://www.acog.org

National Vulvodynia Association
http://www.nva.org

CANADIAN RESOURCES

Canadian Women's Health Network
http://www.cwhn.ca

Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org

References

ACOG Practice Bulletin No. 93: diagnosis and management of vulvar skin disorders. Obstet Gynecol. 2008;111:5):1243-1253.

What is vulvodynia? National Vulvodynia Association website. Available at: http://www.nva.org/whatIsVulvodynia.html. Accessed June 26, 2013.

Vulvodynia. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/vulvodynia.html. Updated August 2010. Accessed June 26, 2013.

Vulvodynia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 25, 2013. Accessed June 26, 2013.

Vulvodynia. National Institute of Child Health & Human Development website. Available at: http://www.nichd.nih.gov/health/topics/vulvodynia/Pages/default.aspx. Updated April 3, 2013. Accessed June 26, 2013.

4/7/2014 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Reed BD, Legocki LJ, et al. Factors associated with vulvodynia incidence. Obstet Gynecol. 2014;123(2.1):225-231.

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