Vulvodynia (say: "vul-vo-din-ee-a") is the word that describes pain and discomfort in the vulva. The vulva is a woman’s external genital area, or the area around the opening to the vagina.
The pain associated with vulvodynia is usually described as a burning, stinging, itching, irritating or a raw feeling. Sexual intercourse, walking, sitting or exercising can make the pain worse.
Vulvodynia usually starts suddenly and may last for months to years. Although it isn't life threatening, the pain may make you cut back on some of your normal activities. It can also make you upset or depressed. It might even cause problems in your relationship with your spouse or partner, because it can make sexual intercourse painful.
The exact cause of vulvodynia isn't known. Some factors may include:
You may need to have a pelvic exam and tests to check for bacteria and yeast. If any test results don't seem normal, your doctor may want you to have a colposcopy or a biopsy. Colposcopy is an exam of the genital area that uses a special magnifying glass. If you have a biopsy, your doctor first numbs your genital area with a painkiller, then takes a small piece of tissue to be looked at with a microscope.
The treatment depends on the cause of your vulvodynia. Some types of vulvar pain get better with creams or pills made to treat yeast infections. Sometimes the pain goes away if you use creams that contain estrogen or cortisone, but cortisone cream isn't good to use for long periods of time. Some antidepressant medicines can help nerve pain and irritation. Other treatments that may help include interferon injections, laser therapy or surgery.
Muscle spasms in your pelvic area can also make vulvar pain worse. Physical therapy or biofeedback treatments (treatments that help you strengthen and relax your pelvic muscles) may help ease the spasms. If you decide to try one of these treatments, look for a therapist trained in women's health. With practice, you can learn to relax your pelvic muscles with exercises you do at home.
Some of the following steps may help ease your symptoms. If they help, keep doing them. If they don't help, stop and talk with your doctor about other possible treatments.
Vulvodynia and Vulvar Vestibulitis: Challenges in Diagnosis and Management by Julius F. Metts, M.D. (American Family Physician March 15, 1999, http://www.aafp.org/afp/990315ap/1547.html)
Written by familydoctor.org editorial staff