Vulvodynia

22nd May 2007 at 12:35 BST by Dr C.A.Jenner MB BS, FRCA. Permalink.

This article discusses the condition of Vulvodynia in detail.

Vulvodynia

Introduction

Vulvodynia is a medical condition characterized by choric vulvar discomfort or pain. This disorder is basically associated with the nerve fibres, making the sensory nerve endings and the skin highly sensitive to touch and sensation.

The term 'vulvodynia' implies painful vulva. The vulva comprises of the pad of fatty tissue at the base of the abdomen and the libia, the clitoris and opening of the vagina.

Incidence and Prevalence

There are certain specific facts regarding the occurrence of vulvodynia and its related symptoms, including:

• It generally occurs in women between the ages of mid-20s to the late 60s.
• Affected women are healthy and active, without any history of chronic health problems.
• A history of sexually transmitted diseases might be present, but it is not necessary.
• The condition is most prevalent amongst white women.

Some research reports also claim the incidence of vulvodynia to be as high as 15% in the entire female population.

Classification of Vulvodynia

Vulvodynia can be classified into various forms, depending on its causative factors and symptoms. Read on for a brief description of each one of them.

a) Vulvar dermatoses

This form of vulvodynia causes itching or pain and can range from being acute to chronic. This condition is often accompanied by physical signs of erythema, erosion and blisters.

b) Cyclic Vulvovaginitis (CVV)

One of the most common forms of vulvodynia, CVV is characterized by a cyclic pain, aggravated during sexual activity.

c) Vulvar Vestibulitis Syndrome (VVS)

VVS is typically characterized by dyspareunia or a pain during intercourse. The patient experiences severe point tenderness on touch and erythema and symptoms are usually aggravated by yeast vaginitis.

d) Dysesthetic Vulvodynia

This form of vulvodynia is most common amongst older women, who are either at menopausal stage.

Symptoms

The specific symptoms of vulvodynia might vary in different individuals, depending on the individual health history and lifestyle patterns. However, there are some typical symptoms that characterize vulvodynia. The most prominent amongst these are:

• Itching
• Rawness
• Throbbing
• Burning
• Stinging
• Soreness
• Pain during intercourse (dyspareunia)
• Dysuria and other urological symptoms

The pain experienced in vulvodynia might be constant or just intermittent and the vulvar tissue may look just minimally swollen. However, the pain and discomfort associated with vulvodynia can have a strong impact on the quality of life of women who suffer from the condition.

In fact, women afflicted with this condition report difficulty in the simple activities like sitting at a desk, bicycle riding, social events and even maintaining a sexual relationship.

Causes of Vulvodynia

A vast series of health and lifestyle-related factors might contribute to the development of vulvodynia. Here we list the main contributing factors:

• Repetitive yeast infections
• Frequently taking antibiotics
• Rashes on the genital area
• Chemical irritation of genital area with from factors like soaps or detergents in clothing
• Laser treatment or surgery on the genital area
• Past or existing genital warts
• Nerve irritation or muscle spasms in the pelvic area

Treatment

To being with, a multi-disciplinary approach is adopted for the treatment of vulvodynia. These primarily include medications, therapies and lifestyle modifications.

Here we briefly list the most important treatment modalities:

a) Medications

• Anti-depressants and anti-epileptic drugs such as amitriptyline, gabapentin and pregabalin
• Creams and lotions such as the 5% Lidocaine that can be obtained over-the-counter
• Fluconazole
• Calcium citrate
• Anaesthetics
• Estrogens

b) Other treatments

• Pain management therapy
• Laser therapy
• Surgery (Vestibulectomy)
• Anticonvulsants
• Physical therapy and biofeedback
• Pelvic floor therapy

c) Non-pharmacologic

• Psychological therapy
• Behaviour modification
• Balanced diet (prefer a low-oxalate diet)

Vulvar Care Measures

There are a vast series of preventive vulvar care measures that you can take to avoid the occurrence of vulvodynia. Here we list the main amongst them:

• Avoid using soap on the affected area. When necessary, just wash off with lukewarm water.
• Don’t use products like petroleum jelly, bath oils, creams, bubble baths sprays and shampoo on the genital area.
• Avoid wearing tight clothing and prefer to wear only cotton underwear and inner.
• Avoid using contraceptive creams and devices.
• Wash genital area under clean running water.
• Use only white, cotton toilet tissue.
• Do not sit in a wet swimsuit for long hours.

Appointments and more information

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