Vulvodynia

Overview

What is vulvodynia?

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.

Symptoms

What are the symptoms of vulvodynia?

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.

Causes & Risk Factors

How did I get vulvodynia?

The exact cause of vulvodynia isn’t known. Some factors may include:

  • Frequent yeast infections or sexually transmitted infections
  • Chemical irritation of the external genitals (from soaps, feminine hygiene products or detergents in clothing)
  • Rashes on the genital area
  • Previous laser treatments or surgery on the external genitals
  • Nerve irritation, injury or muscle spasms in the pelvic area
  • Diabetes
  • Precancerous or cancerous conditions on the cervix

Diagnosis & Tests

How is vulvodynia diagnosed?

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.

Treatment

How is vulvodynia treated?

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.

What else can I do to help my symptoms?

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.

  • Try to avoid using soap in the genital area. Just wash with water. Don’t use creams, petroleum jelly, bubble baths, bath oils or feminine deodorant sprays.
  • Wash your genital area frequently with plain water to wash away any vaginal secretions that may cause irritation. Rinse with clear water from a squeeze bottle after urinating.
  • Wear only all-cotton underwear and loose clothing. Avoid wearing pantyhose or other close-fitting synthetic clothing.
  • Use only white, unbleached toilet tissue and 100% cotton unscented sanitary products (tampons and pads).
  • Report any increased discharge and irritation to your doctor so that yeast and bacterial infections can be treated right away.
  • Try to avoid using contraceptive devices and contraceptive creams that might irritate your genital area. Talk with your doctor about other methods of birth control.
  • Wash new underwear before wearing. Always rinse underwear thoroughly after washing to remove soap residue.
  • Don’t sit around in a wet swimsuit for a long period of time. Doing so can cause an excess of bacteria and yeast in the genital area.

Questions to Ask Your Doctor

  • What is the likely cause of my pain?
  • Do I need any tests?
  • What can I do to relieve my pain?
  • Will medicine or some other treatment help?
  • Is it safe for me to have sex? What if the pain starts to interfere with my relationship?

Citations

  • Vulvodynia and Vulvar Vestibulitis: Challenges in Diagnosis and Management by Julius F. Metts, M.D.( 03/15/99, http://www.aafp.org/afp/990315ap/1547.html)