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Vulvodynia is a chronic, life-altering pain in your vulva that keeps you away from engaging in activities you enjoy. It is also the most common cause of pain during sexual intercourse and premenopausal women. It is estimated that around 8 to 10% of women of all ages and ethnicity suffer from pain in the vulva. In India, due to cultural and social factors, there is low awareness and diagnosis of the condition, leading to underreporting. Regardless of the incidence, it is important to diagnose and treat this condition, as it can be severe, debilitating, and devastating to the affected women. In this blog post, we aim to provide a comprehensive understanding of vulvodynia and the steps one can take to treat it.
Synopsis
What Is Vulvodynia?
Vulvodynia can be defined as chronic pain in your vulva (an external female genital area), vagina, or genitals that can develop due to no apparent reason. The pain can last for three months or longer. The pain in the vulva can be so stressful that it affects your work, relationships, and sleep. Overall, the vulvodynia can have a significant impact on the women’s quality of life.
Types of Vulvodynia
Depending on where the pain originates, vulvodynia is classified into two types:
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Localised Vulvodynia: Pain is felt in one particular spot, usually the vulvar vestibule or clitoris.
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Generalised Vulvodynia: Individuals experience pain in different parts of the vulva or vagina at different times.
Likewise, depending on if there is a provoking aspect, it is classified as provoked vulvodynia (caused by sexual intercourse or swab) or unprovoked vulvodynia (no provoking cause) or mixed.
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Vulvodynia Symptoms
Affected individuals experience pain in the vulva, which feels different from person to person. Women may experience burning, stabbing, throbbing, stinging, itching, or rawness, which can be mild or severe. The timing when the pain starts and stops also differs among women but is known to intensify with activities like walking, running, exercising, or indulging in sex. Many women with this condition develop frustration, chronic stress, and depression.
Vulvodynia Causes
The exact cause for developing vulvodynia remains elusive. However, potential causes include:
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Hormonal factors
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Genetic factors that increase the susceptibility to pain syndromes such as fibromyalgia, painful bladder syndrome, and irritable bowel syndrome.
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Inflammation or direct trauma to the vulva (episiotomy)
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Hormonal changes caused by intake of birth control pills or menopause
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Nerve injury or irritation
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History of chronic vaginal infections, possibly vaginal fungal infection or urovaginal infections
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Muscle spasms or weakened pelvic floor muscles
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Psychological factors like anxiety, depression, and post-traumatic stress disorder increase your likelihood of developing this condition.
Vulvodynia Management
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Use mild, unscented soap while washing your vulva.
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Use cotton or loose-fitting undergarments.
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Apply cold compresses to the vulva for 15 minutes.
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Get adequate sleep
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Incorporate stress reduction methods into your daily routine.
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If you have to sit for prolonged periods, use cushions that reduce pressure on your vulva.
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Use lubrication with non-irritating agents during sexual intercourse.
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Vulvodynia Treatment
Treatment for vulvodynia is aimed at bringing the pain under control; however, the effect is gradual. Some of the treatment options are:
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Medications: Topical medications like oestrogen or a combination of oestrogen and progesterone may be prescribed to numb your vulva. Additionally, you can be given antidepressants and anticonvulsants to reduce your nerve pain.
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Nerve Blocks: Injections may be administered near the affected region to prevent pain signals from reaching the brain. A combination of steroids and bupivacaine is effective in reducing symptoms of vulvodynia.
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Physical Therapy: It helps relieve muscle tension, reduce the frequency of spasms, and strengthen the pelvic muscles through stretching, lengthening, and strengthening exercises.
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Transcutaneous Electrical Nerve Stimulation: This is an emerging treatment for vulvodynia. It helps address pain syndrome and improve sexual function in women with vulval pain.
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Vestibulectomy: If conservative measures fail and the pain is localised to the vestibule, a part of your vulva that is painful has to be removed.
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Laser Therapy: Ablation with KTP-ND: YAG or CO2 lasers presents an effective alternative to Vestibulectomy, as they demonstrate comparative results similar to the surgical procedure.
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Counselling: These sessions can help overcome the sexual relationship issues that arise from vulvodynia. Cognitive Behavioural Therapy is also known to reduce vulvar pain during sexual intercourse.
Even though a multitude of options are available for patients to treat vulvodynia, you must remember that no single treatment is effective for all. Therefore, an individualised, comprehensive, and multidisciplinary approach is required to treat vulva pain and related distress.
Conclusion
The burden of vulvodynia in a woman’s life can be devastating due to its consequences on intimacy, daily activities, and psychological well-being. If you have chronic vulval pain and are dealing with its negative consequences, seek expert care at Manipal Hospitals, Patiala.
FAQ's
If you have vulval pain, your healthcare provider will rule out the most common causes of the pain first. A detailed medical history, with current symptoms, sexual history, past treatments, allergies, and infections will be taken. Your vulva and vagina will be carefully examined and a sample of discharge is taken from the site. A Biopsy of the site may also be taken.
Trigger Point Therapy is a form of massage therapy. A trigger point is an area of tightly contracted muscle from where pain travels to nearby areas. Therefore, a soft tissue massage to relax this area or a nerve block can be injected into the area for pain relief.
Anxiety and depression are the consequences of vulvodynia. Pre-existing stressors and fear of anticipated pain can worsen the symptoms. Most often, the sexual relationships of the affected individual suffer.
Vulvodynia is often an unprovoked, spontaneous pain that has a burning sensation, whereas vestibulodynia is a provoked pain arising from light touch such as tampon use or sexual intercourse.
You can schedule an appointment at Manipal Hospitals, Patiala, by contacting us or visiting our website.
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