Vulvodynia is just beginning to come on the radar screen of the medical profession and researchers. Generally speaking, vulvodynia is defined as chronic vulvar discomfort or pain, characterized by burning, stinging, irritation or rawness of the female genitalia in cases in which there is no infection or skin disease of the vulva or vagina causing these symptoms. Read more about what vulvodynia is.
There is no known cause of vulvodynia. Researchers are considering several possibilities:
- Injury to, or irritation of, the nerves that innervate the vulva
- An abnormal response of different cells in the vulva to environmental factors (such as infection or trauma)
- Genetic factors associated with susceptibility to chronic vestibular inflammation
- A localized hypersensitivity to candida (yeast)
- Spasms of the muscles that support the pelvic organs
Vulvodynia is diagnosed in part by ruling out all other causes of vulvar pain. You doctor will likely take a complete history, do an examination of the vulva, vagina, and vaginal secretions, as well as perform fungal vaginal cultures to rule out infection. They may do a “q-tip test” where they touch different areas of the vulva and vestibule to determine the location and severity of pain. They may take a biopsy of skin that looks suspicious, and/or recommend a colposcopy.
What are the treatment options with vulvodynia?
There is currently no "cure" for Vulvodynia. Treatments are directed toward alleviation of symptoms and may provide partial or complete relief. It is important to keep in mind that the cause of vulvodynia is unknown and each woman’s symptoms are unique; no single treatment works all the time or is appropriate for every patient. Some women respond very well to a particular treatment, while others respond poorly or experience unacceptable side effects. It takes time to find a treatment or combination of treatments that will decrease or alleviate your pain.
Some of the current treatments available (not listed in order of efficacy) include:
- Discontinuation of all topical medications, soaps, douches, etc., that can worsen irritation
- Local anesthetics (i.e. lidocaine)
- Tricyclic antidepressant medications (e.g., amitriptyline, nortriptyline, desipramine)
- Anticonvulsants (e.g., Tegretol, Neurontin)
- Interferon injections
- Nerve blockades
- Topical estrogen cream
- Pelvic floor therapy (for patients who have pelvic floor muscle abnormalities as measured by surface electromyography)
- Physical therapy
- Diet modification
- Surgery (for vulvar vestibulitis syndrome only)
The information on this page was reprinted with permission from the National Vulvodynia website.
