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Definition
Vulvodynia is chronic pain or discomfort in the vulva, which are external female genitalia (often called the lips of the vagina). The vulva includes the labia, clitoris, and vaginal opening.
Female Genitalia
2008 Nucleus Medical Art, Inc.
Causes
The causes of vulvodynia are not well known.
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 colposcopevisual examination of the vulva and vagina using a lighted magnifying instrument
- Biopsyremoval of a sample of tissue for testing
Treatment
Talk with your doctor about the best treatment plan for you. Treatment options include:
MedicationsTopical anesthetics (eg, lidocaine, xylocaine), estrogen creams, and corticosteroid creams can be used to help manage pain. Sometimes injections of steroid into the skin (combined with local anesthetic) may be used. In addition, there is some evidence that tricyclic antidepressant medications (eg, amitriptyline, nortriptyline, and desipramine) can relieve pain and irritation. Other medications such as Neurontin, Cymbalta, and Lyrica are sometimes tried. Physical TherapyPhysical therapy to help you strengthen and relax your pelvic muscles can ease muscle spasms. This requires a physiotherapist with special training and interest in pelvic floor physiotherapy. Other TreatmentsInterferon injections, laser treatments, and surgery have also been suggested for the treatment of vulvodynia. PreventionThere is no known way to prevent vulvodynia, since the causes are not well-understood. RESOURCES: American College of Obstetricians and Gynecologistshttp://www.acog.org National Vulvodynia Associationhttp://www.nva.org National Women's Health Information Centerhttp://www.4woman.gov New York Center for Vulvovaginal Painhttp://www.vulvodynia.com CANADIAN RESOURCES: Canadian Women's Health Networkhttp://www.cwhn.ca/indexeng.html 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 April 2008 by Ganson Purcell Jr., MD, FACOG, FACPEPlease 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.
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