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Vulvodynia Alternative Names
essential vulvodynia, pudendal neuralgia, chronic essential vulvar pain
Definition
Vulvodynia is the medical term for pain the in the vulva area of a women's body. The term is generally reserved for chronic pain in the vulva with no known cause.
What is going on in the body?
The vulva is a general term for the external part of a woman's genitals. The vulva includes the area of skin directly above the vagina, the clitoris, the inner and outer labia or lips of the vagina, the opening to the vagina, and the urethra. The urethra is the tube that carries urine from the bladder to the outside of the body. Pain in the vulva can be due to many known conditions. These include infection, injury, and allergic reactions to medications, soaps, or feminine products. If no cause can be found, the condition is called vulvodynia.
What are the signs and symptoms of the condition?
Symptoms of this condition include: - discomfort in the vulva area. This is often described by affected women as pain, burning, stinging, itching, aching, stretching, throbbing, or irritation.
- pain only when pressure is applied to the opening of the vagina. This usually only occurs in a subtype of vulvodynia known as vulvar vestibulitis. The vestibule is a term that describes the opening to the vagina. In this subtype, redness is often seen in the painful area during flare-ups. Pain may make sexual intercourse impossible, and may even be aggravated by walking, sitting, or riding a bike.
- depression, often due to frustration from the chronic pain and the ineffectiveness of most treatments
What are the causes and risks of the condition?
This condition is usually diagnosed when no cause for a woman's pain can be found. Though different theories exist as to why this condition occurs, the exact cause is unknown. This condition occurs most often in middle-aged white women.
The main risks of this condition are frustration and depression. True vulvodynia does not result in any physical health risks and is not related to cancer.
What can be done to prevent the condition?
There are no ways known to effectively prevent this condition.
How is the condition diagnosed?
Before a diagnosis of this condition can be made, treatable causes of pain in the vulva must be ruled out. A history and physical examination are first done. Several steps may be involved to rule out other conditions. The doctor may: - take swabs of the vulva to check for infections
- suggest that the person stop using soap, fabric softeners, scented toilet paper, and any feminine products to make sure there is no allergic reaction causing the pain
- prescribe certain medications, such as topical drugs or antibiotic pills, to treat a possible underlying infection
- take a biopsy of the vulva. This is a procedure to remove a small piece of tissue from the vulva. This tissue can then be looked at with a microscope.
If these tests and procedures do not reveal a cause for the pain, vulvodynia is generally diagnosed.
What are the long-term effects of the condition?
There are no long-term physical effects from this condition. Affected women may become frustrated or depressed, however, and their relationships may suffer.
What are the risks to others?
There is no risk to others as this is not a contagious condition.
What are the treatments for the condition?
There is no known cure for this condition. Many different types of treatment may be tried. Different women respond to different treatments, and some women do not respond at all. Common treatments include: - avoidance of soaps and other products that may irritate the area
- special diets, such as a diet low in oxalate. Oxalate is found in many different foods, such as celery and grapes.
- local "numbing" creams, which can be used before sex to reduce discomfort in some women
- antidepressant drugs, such as amitriptyline or fluoxetine
- chronic pain drugs, such as valproate, a drug sometimes used to treat seizures
- biofeedback. This is a process by which people learn to control certain body functions they are not usually aware of. For instance, women can be taught to reduce muscle spasms in the vagina.
- support groups, which help women deal with their frustration by meeting others with a similar problem
- surgery, which is only used for severe cases that do not respond to any other treatments
- steroid creams and ointments remain the most effective treatment
Treatment must be tailored to each woman. Many women get better eventually, even without treatment.
What are the side effects of the treatments?
All medications have possible side effects. These include allergic reactions, stomach upset, and others. Specific side effects depend on the drugs used. Surgery carries a risk of bleeding, infection, and reaction to any pain medications used.
What happens after treatment for the condition?
No treatment is guaranteed to be effective. Many women go through many treatments before they find one that works for them. The course of the condition is unpredictable. Some women have symptoms that come and go, whether treatment is used or not.
How is the condition monitored?
Women generally monitor their symptoms at home. They should report any changes to their doctors.
Author: Gail Hendrickson, RN, BS
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request |
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