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Vulvodynia
Definition
Vulvodynia is chronic pain or discomfort in the vulva. The vulva is often called the lips of the vagina. The vulva includes:
- Labia (labia majora and labia minora)
- Clitoris
- Vaginal opening
Female Genitalia
© 2009 Nucleus Medical Art, Inc.
Causes
The causes of vulvodynia are not completely known but may include:
- Infection
- Changes in the vulvar tissue
- Perhaps abnormal nerve sensation
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 low-power microscope
- Biopsy —removal of a sample of tissue for testing
Treatment
Talk with your doctor about the best plan for you. Treatment options include:
Medications
To help manage pain:
- Topical anesthetics (eg, lidocaine , xylocaine)
- Estrogen creams
- Corticosteroid creams
- Injections of steroid into the skin—may be used
For pain and irritation relief:
- Tricyclic antidepressant medications—research has shown a potential effect
Other medications that are sometimes tried include:
Physical Therapy
Therapy can help you strengthen and relax your pelvic muscles. This will ease muscle spasms. You will need to see a specialist in pelvic floor issues.
Other Treatments
Suggested treatments for vulvodynia include:
- Interferon injections
- Laser treatments
- Surgery
RESOURCES:
American College of Obstetricians and Gynecologists
http://www.acog.org/publications/patient_education/
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/
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 January 2009 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.
Copyright © 2007 EBSCO Publishing All rights reserved.