Vulvodynia

Definition

Vulvodynia is chronic pain or discomfort in the vulva, which are external female genitalia (often called the “lips of the vagina”). The vulva includes the labia, clitoris, and vaginal opening.

Female Genitalia

si55550966_96472_1_vulva.jpeg

© 2008 Nucleus Medical Art, Inc.

Causes

The causes of vulvodynia are not well known.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors are thought to increase the risk of vulvodynia:

  • 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
  • History of genital warts
  • Pelvic nerve irritation or muscle spasms
  • History of sexual abuse
  • History of domestic violence

Symptoms

Symptoms of vulvodynia may include:

  • Pain of the vulva, which may come and go
  • Burning of the vulva
  • Stinging of the vulva
  • Irritation of the vulva
  • Rawness of the vulva

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:

  • Pelvic exam
  • Tests to check for bacteria and/or yeast
  • Magnified exam, using a colposcope—visual examination of the vulva and vagina using a lighted magnifying instrument
  • Biopsy—removal of a sample of tissue for testing

Treatment

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

Medications

Topical anesthetics (eg, lidocaine, xylocaine), estrogen creams, and corticosteroid creams can be used to help manage pain. Sometimes injections of steroid into the skin (combined with local anesthetic) may be used.

In addition, there is some evidence that tricyclic antidepressant medications (eg, amitriptyline, nortriptyline, and desipramine) can relieve pain and irritation. Other medications such as Neurontin, Cymbalta, and Lyrica are sometimes tried.

Physical Therapy

Physical therapy to help you strengthen and relax your pelvic muscles can ease muscle spasms. This requires a physiotherapist with special training and interest in pelvic floor physiotherapy.

Other Treatments

Interferon injections, laser treatments, and surgery have also been suggested for the treatment of vulvodynia.

Prevention

There is no known way to prevent vulvodynia, since the causes are not well-understood.

RESOURCES:

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

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

National Women's Health Information Center
http://www.4woman.gov

New York Center for Vulvovaginal Pain
http://www.vulvodynia.com

CANADIAN RESOURCES:

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

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

References:

About vulvodynia. National Vulvodynia Association website. Available at: http://www.nva.org/about_vulvodynia/what_is_vulvodynia.html. Accessed April 20, 2007.

Vulvodynia. American Academy of Family Physicians website. Available at: http://familydoctor.org/367.xml. Accessed April 20, 2007.

Vulvodynia. National Institute of Child Health & Human Development website. Available at: http://www.nichd.nih.gov/health/topics/Vulvodynia.cfm. Accessed April 20, 2007.



Last reviewed April 2008 by Ganson Purcell Jr., MD, FACOG, FACPE

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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