Understanding Vulvodynia: Symptoms, Causes, and Treatment Options
Vulvodynia is a long name for a chronic pain condition that affects at least 8% of women all over the world. It may not be something you hear discussed while out with your girlfriends, but awareness and education about vulvodynia is growing. In this article, we will expand on what vulvodynia is, what causes it, and how it can be treated.
What is Vulvodynia?
In the simplest of terms, vulvodynia is a diagnosis given to people living with vulvar pain (this can also be pain in the vagina, around the vagina or genital area) that lasts 3 or more months. The pain in vulvodynia is different from other types of pain because it has no identifiable cause like an infection or injury. Vulvodynia doesn’t hurt in the same place or same way for all women. For some women, it causes pain in one specific spot, while in others it hurts in many different places. In the same way, it can cause different types of pain, burning sensations for some, or stabbing pains for others.
The national vulvodynia association separates vulvodynia into two types: localized and generalized.
Localized Vulvodynia:
- Pain is located in just one spot
- Pain is usually experienced with pressure or touch (such as when one attempts to use tampon,have sex, or the use of a speculum. Others can have pain simply with sitting or wearing tight clothing)
Generalized Vulvodynia:
- Pain in more than one spot and tends to be more generalized
- Pain is more or less constant and can come on with or without a cause
- Pain can be made worse by pressure or contact
How Common is Vulvodynia and Who Gets it?
Real numbers aren’t precise since it is thought that many women do not talk about nor seek medical help for their pain. At least 8% of women have vulvodynia and most are diagnosed between the ages of 20-60.
Vulvodynia Symptoms
There are many different symptoms of vulvodynia, and they can vary from person to person. In general the symptoms in and around the vulva can include:
- Itching
- Throbbing
- Aching
- Swelling
- Pain (aching, burning, stabbing)
- Rawness
- Stinging
- Tightness
What Causes Vulvodynia?
Nobody knows for sure, as research is ongoing to find a cause. It is likely that there are several things that could cause it, such as:
- Inflammation
- Unbalanced Hormones
- Genetics
- Problems with nerves
- Issues stemming from old infections or injuries
- Pelvic floor dysfunction (weakness or spasms in the pelvic floor and associated muscles)
- Reactions to products or chemicals like lotions, soaps, and detergents
Impact of Vulvodynia on Daily Life
Vulvodynia can seriously affect the daily life of women in many ways. Because of the location of the vulva, any activities that involve sitting or pressure in the vulvar area can be painful. In addition, any clothing that is tight-fitting can be uncomfortable to the area.
The discomfort from vulvodynia can also make it hard for people to fall asleep and stay asleep. Not to mention, those living with vulvodynia usually also eventually experience varied types of sexual dysfunction.
Symptoms can also be triggered or made worse by any form of contact ro touch such as during sexual activity, tampon insertion, exercise, or medical examinations like pap smears.
Vulvodynia Therapy
So, how is vulvodynia treated? There are several options out there, and some work better for some women than others. The main treatments available are:
Pelvic Physical Therapy: A visit to an experienced pelvic floor physical therapist is one of the most effective ways to get discomfort from vulvodynia under control. Your pelvic physical therapist can use a variety of techniques, which should include, manual therapies, education on and assistance in calming the nervous system, and exercises, to help release tension and ease pain.
Medications: Though most are only temporary fixes, medications that treat pain, numb or block pain can be helpful for a time. There are both topical creams and injected agents that can be used.
For some women, antidepressant medications that are prescribed for pain can also be helpful. Remember never to start, change or stop any medications or creams without asking your doctor first.
Cognitive Behavioral Therapy: CBT has been shown to be helpful for some women in reducing the discomfort caused by vulvodynia.
Vaginal Dilators: Vaginal dilators can be helpful for some women with vulvodynia by gradually stretching the vaginal opening to ease tightness that can cause pain.
There are other things you can try at home to reduce your discomfort. Avoid strong soaps and detergents, wear looser-fitting breathable underwear and clothing, and if you have tailbone pain, you can try a donut cushion for prolonged sitting.
Is there a Vulvodynia Specialist?
Several different healthcare professionals treat women with vulvodynia. This includes doctors, OB/Gyns, therapists, physical therapists and more. As far as training that is specialized in treating pelvic pain and vulvar pain, a pelvic floor physical therapist is one of the most qualified.
If you or someone you know has vulvodynia, look in your local area for a pelvic floor physical therapist and make an appointment to see if they can help.