Vulvodynia



This is an excerpt from an article in guardian - "It was after a spate of kidney infections that I started experiencing intimate pain, including a burning and stinging sensation on the skin around my vulva whenever I attempted to sleep with my partner or insert a tampon. I was a student at the time and the first move of the campus GP was to test me for chlamydia. Although this came back negative, I was tested for the same infection a further three times over the following months. Then I was sent to a sexual health clinic, despite the fact I had one long-term partner and my situation had not changed. Assumptions were being made about me, I felt, because I was a student, and I was embarrassed that neither my GP nor the clinic staff would believe I was having safe sex. "https://www.theguardian.com/commentisfree/2017/mar/28/gynaecologists-pain-women-vulvodynia-misdiagnoses

I shared this because, this is a story I have heard from many of my patients. A lot of them end up being of years of antibiotics, many of them are dismissed by their GP, of other health care professionals. Also, for a lot of women, it takes months, sometimes years to get correct diagnosis!


So what is Vulvodynia

Vulvodynia is a chronic pain condition, where there is pain, usually burning in nature in the vulva which can include vestibule, urethra, clitoris, labia. It can occur with touch, such as placing a tampon or with sexual intercourse. It can also occur spontaneously without any touch or pressure!

  • Studies have not been have to figure out a cause but the precipitating factors can be different.


What can be symptoms of Vulvodynia

The most common symptom is burning pain. Sometimes, women report feeling aching, soreness, throbbing, irritation and itching. The pain may be present all the time, or may come and go. The pain may be mild or severe and sometimes it can be so bad that it prevents sexual intercourse. Sometimes, vulvodynia can co-exist with other conditions such as interstitial cystitis, fibromyalgia, irritable bowel syndrome, and endometriosis. Postmenopausal women may also experience vulvodynia because of a lack of estrogen. In other cases, vulvodynia can be associated with anxiety, depression, disability and pelvic floor muscle dysfunction which may present with urinary symptoms (frequency, urgency) or bowel symptoms (constipation). Vulvodynia pain is NOT usually associated with bleeding or foul vaginal discharge; these symptoms are more consistent with other diagnosis.


What can you do to help?

Pelvic Physical Therapy and Cognitive Behavioral Therapy (CBT) are the primary treatments confirmed by research to be most effective. These types of therapy have been shown by research to improve pain and sexual function. Depending on severity, local anesthetics and other medications might also be added to the treatment. Topical hormonal creams may be especially helpful in post-menopausal women.


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