• Vulvodynia

    Vulvodynia

Vulvodynia

 Vulvodynia is described as chronic pain in the vulva without an identifiable cause. Vulvodynia is a fairly common condition that affects one in four women. The main vulvodynia symptom is pain in your genital area, which can be characterized by:

  • Burning
  • Soreness
  • Stinging
  • Rawness
  • Painful intercourse (dyspareunia)
  • Throbbing
  • Itching

Many women with vulvodynia have a history of treatment for recurrent vaginitis or vaginal yeast infections. Some women with the condition have a history of sexual abuse. But most women with vulvodynia have no known contributing factors. Vulvodynia isn't sexually transmitted or a sign of cancer. Because it can be painful and frustrating and can inhibit sexual activity, vulvodynia can cause emotional problems. Some women experience this pain for a course of several years; some describe their pain as occurring in cycles.

To learn about the possible treatment options of vulvodynia, click on any of the tabs below.

 

Behavioral Modifications

  • Try cold compresses. Cool compresses placed directly on your external genital area may help lessen pain and itching.
  • Soak in a sitz bath. Two to three times a day, sit in comfortable, lukewarm (not hot) or cool water for five to 10 minutes.
  • Avoid tight fitting pantyhose and nylon underwear. Tight undergarments restrict airflow to your genital area, often leading to increased temperature and moisture that can cause irritation. Wear white, cotton underwear to increase ventilation and dryness, and sleep without underwear at night.
  • Avoid hot tubs and soaking in hot baths. Spending time in hot water may lead to discomfort and itching.
  • Avoid activities that put pressure on your vulva, such as biking or horseback riding.
  • Wash gently. Washing or scrubbing the affected area harshly or too often can increase irritation. Instead, use plain water to gently clean your vulva with your hand and pat the area dry. After bathing, apply a preservative-free emollient, such as plain petroleum jelly, to create a protective barrier.
  • Use lubricants. If you're sexually active, apply lubricants before engaging in sexual intercourse.
  • Try an antihistamine at bedtime. This may help reduce itching and help you rest better.

Physical Therapy

Vulvodynia treatments focus on relieving symptoms. No one treatment works for every woman, and you may find that a combination of treatments works best for you. It may take weeks or even months for treatment to improve your symptoms noticeably. Options may include:

Biofeedback Therapy
This therapy can help reduce pain by teaching you how to control specific body responses. The goal of biofeedback is to help you relax to decrease pain sensation. To cope with vulvodynia, biofeedback can teach you to relax your pelvic muscles, which can contract in anticipation of pain and actually cause chronic pain.

Pelvic Floor Therapy
Many women with vulvodynia have problems with the muscles of the pelvic floor, which supports the uterus, bladder and bowel. Exercises to strengthen those muscles may help relive vulvodynia pain.

Medical Therapy

Tricyclic antidepressants or anticonvulsants may help lessen chronic pain. Antihistamines may reduce itching. Medications, such as lidocaine ointment, can provide temporary symptom relief. Your doctor may recommend applying lidocaine 30 minutes before sexual intercourse to reduce your discomfort. If you use lidocaine ointment, your partner also may experience temporary numbness after sexual contact. Women who have long-standing pain that doesn't respond to other treatments may benefit from local injections of nerve blocks.

Surgery

Dr. Steinberg currently does not recommend surgery for this condition.

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