Women who suffer from pain or discomfort around the vaginal opening or vulvar region may have a condition called vulvodynia. Symptoms may include pain, burning, or irritation without any visible signs of a rash or lesions. Often times, discomfort during sexual intercourse accompanies the condition. Some women, in the absence of visible signs may try to ignore the condition. However, there are ways to diagnose and treat vulvodynia. Any intermittent or continued vulvar pain should be reported to your healthcare provider.
Vulvodynia symptoms may include soreness, stinging or burning, feeling of rawness or tenderness, as well as itching. The pain may be intermittent, constant, or only when touched or during intercourse. Usually the vulvar will appear normal; however, the tissue may be inflamed.
Your healthcare provider will first rule out other common gynecological conditions which may present with similar symptoms including yeast infection or bacterial infections, viral infections such as herpes or genital warts, as well as precancerous skin lesions or health problems. Once these other conditions are ruled out, they may suspect vulvodynia.
The exact cause of vulvodynia is unknown, but there are several possibilities including past vaginal infections, hormonal changes, allergies, or sensitivity to chemicals that may be present in soaps or fabrics. Other causes may include damage to nerves in the vulvar region or issues with the muscles that support the pelvic floor. While the exact causes of vulvodynia are not well understood, it is possible to diagnose and treat this fairly common condition. Proper diagnosis begins with consulting with a medical provider who specializes in gynecological conditions.
The first step in accurately diagnosing the condition is a complete history and physical that will include a review of your medical, surgical, and sexual history. Your provider may perform a pelvic exam to ascertain any evidence of infections or other reasons for your symptoms. They may take a specimen of cells to test for yeast, bacteria, or viruses. They may also use a moistened cotton swab to test for sensitivity in the vulvar area. If an infection is identified, you will be given medication to target the specific problem. However, if no infection is present, your healthcare provider may begin one or several courses of treatment to alleviate pain.
Treatment can begin with medications to reduce pain including steroids, anticonvulsants, or antidepressants that are often used for chronic pain. Additionally, antihistamines may help with itching. They may also prescribe a lidocaine ointment used prior to sexual intercourse to reduce discomfort. The use of local anesthetics may induce temporary numbing for a sexual partner as well. Another method of treatment to minimize pain is a nerve block injection for women who have not responded to other treatments.
Biofeedback therapy as well as pelvic floor therapy may help vulvodynia sufferers learn to exercise and relax surrounding pelvic muscles, which may help to reduce pain. In more extreme cases, where other treatments have not worked, surgery to remove affected skin and tissue may give pain relief. Coming up with a successful treatment plan can help avoid some of the more common complications of vulvodynia, which include depression and anxiety as well as sleep problems and sexual and relationship issues.
In addition to medical solutions, many women have some success with homeopathic remedies, including cold compresses or sitz bath soaks. Avoiding certain irritants such as tight undergarments, synthetic fabrics, and hygiene products made of synthetic materials and perfumes may help to alleviate symptoms. Using cotton-only underwear and hygiene products is also recommended, as well as limiting the use of soaps that may irritate the vulvar area.
Using a lubricant during sexual intercourse may help to mitigate pain but be sure to avoid products which contain alcohol or fragrances which may exacerbate the problem. Finally, vulvodynia can be a stressful condition, and unfortunately stress tends to worsen many health conditions, so trying to reduce stress through a variety of methods including meditation, exercise, therapy, and self-care may help to lessen the associated symptoms.
If you are experiencing vulvar sensitivity or pain, don’t be timid about seeking out help. The key to successful treatment is having a frank and honest discussion with your health care provider about your symptoms and concerns.
