What Is Vulvodynia?
As many as 16 percent of women will experience vulvodynia at some point in their lives, according to the National Vulvodynia Association (NVA). Vulvodynia is when you have chronic pain in the vulva (the external female genital area) without an identifiable cause. A diagnosis of vulvodynia requires that the pain lasts three months or longer and is not caused by an infection, skin disorder, or other medical condition, according to the American College of Obstetricians and Gynecologists (ACOG).
The main symptom is pain
Each person might experience the pain of vulvodynia differently. You may feel sensations of burning, stinging, aching, soreness, itchiness, irritation, or rawness. You might also have throbbing pain or notice swelling. The pain might only be in only one area of vulva or can be in multiple areas.
The vulva is made up of three main parts:
Labia: the inner and outer lips of the vagina
Vestibule: the area surrounding the opening to the vagina and the opening to the urethra
Perineum: the area between the opening of the vagina and the anus
When pain is in only one of these areas, it is considered localized. When pain occurs throughout the vulva, it is considered generalized.
The pain and discomfort can be severe. Sixty percent of women with vulvodynia indicate that it interferes with their enjoyment of life and prevents them from having sex, according to the National Women’s Health Resource Center.
Some women report symptoms are constant. Others indicate that symptoms only occur after being touched or having pressure put on the vulva. These triggers could include vaginal intercourse, inserting a tampon, having a gynecological exam, sitting for long periods of time, or wearing tight pants, according to the NVA.
Causes and diagnosis
The exact cause of vulvodynia isn’t understood. But we do know that it isn’t caused by infection, the human papillomavirus (HPV), sexually transmitted diseases, or neurological disorders. It is diagnosed after eliminating any other causes of vulvar pain.
Researchers believe there are several factors that might contribute to vulvodynia:
Vulvar nerve damage
Inflammation of the vulva
Weakness in pelvic floor muscles
Reccurent yeast infections
Previous injury or infection of the vulva
Diagnosis can sometimes be difficult. Some medical professionals aren’t aware of the condition, and women are often reluctant to discuss the symptoms with their doctor. Some women, according to National Women’s Health Resource Center, report not being taken seriously or being told their pain is all in their head. Sixty percent of women report having consulted at least three medical professionals about their pain, with many women never receiving a diagnosis, according to the NVA.
Once other causes of the pain are eliminated, your doctor will perform a complete physical evaluation, which might include taking a sample of vaginal discharge and using a cotton swab to touch different parts of your vulva. This cotton swab test is used to determine if the pain is localized or generalized and to measure its severity, according to ACOG.
There are several different treatments for vulvodynia, according to ACOG. Your doctor’s recommendations will be based on your symptoms and when symptoms are most likely to occur. Some treatments include:
Local anesthetics may be applied directly to the skin. These can be used as a preventative measure (for example, applying them before vaginal intercourse) or can be used for short-term relief when pain is interfering with your daily activities.
Antidepressants and anti-seizure medications can sometimes help reduce symptoms.
Estrogen creams may help relieve pain.
Physical therapy and trigger point therapy may help relax pelvic floor muscles.
Nerve blocks, where anesthetic drugs are injected into the nerves that are causing pain, may be used.
Cognitive behavioral therapy can sometimes helpful for dealing with chronic pain.
Surgery to remove painful tissue from the vulva is sometimes used when other treatments have not worked.
Pain relief tips
In addition to medical treatment, there are lifestyle changes you can make to help relieve some of the pain and discomfort, according to the National Institutes of Health:
Wear 100 percent cotton underwear.
Avoid wearing underwear at night.
Avoid tight-fitting underwear and clothes.
Use mild soaps.
Clean vulva with water only.
Avoid vaginal wipes, female deodorants, and bubble baths.
Use lubricants during vaginal intercourse.
Apply cool gel packs to relieve pain.
Avoid exercises that put direct pressure on vulva, such as bike riding.