Vulvodynia

  • Definition

    Vulvodynia is chronic pain or discomfort of the vulva. The vulva includes the:
    • Labia majora and labia minora
    • Clitoris
    • Vaginal opening
    Female Genitalia
    si55550966 96472 1 vulva.jpeg
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  • Causes

    The cause of vulvodynia is not known. Some possibilities include:
    • Injury or irritation of vulvar nerves
    • Inflammed tissue
    • Abnormal response to infection or trauma
  • Risk Factors

    Vulvodynia is more common in women who are younger. Other factors that increase your chance of developing vulvodynia include:
    • History of vulvodynia
    • Chronic pain or disorders associated with chronic pain
    • Sleep disturbances
    • Some mental health disorders, such as post-traumatic stress disorder
    • Recurrent yeast infections
    • Frequent use of antibiotics
    • Irritation to the genitals by soaps or detergents
    • Genital rashes
    • Previous treatment or surgery to the external genitals
    • Pelvic nerve irritation or muscle spasms
  • Symptoms

    Symptoms may include:
    • Pain, which may come and go
    • Burning
    • Stinging
    • Irritation
    • Rawness
  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. It may include a pelvic exam. The affected area may need to be examined closely. This can be done using a colposcope to magnify the area.
    Your bodily tissues and fluids may need to be tested. This can be done with:
    • Tests to check for bacteria and/or yeast
    • Biopsy
  • Treatment

    Talk with your doctor about the best treatment plan for you. Options include:
    Medications
    • Topical medications that are applied to the skin, such as corticosteroids, estrogen, or anesthetics
    • Antidepressants
    • Anticonvulsants
    • Prescription pain relievers
    Physical Therapy
    Therapy can help you strengthen and relax your pelvic muscles. This will ease muscle spasms. You may be referred to a doctor who specializes in pelvic floor issues.
    Other Treatments
    Suggested treatments for vulvodynia include:
    • Injections
    • Nerve stimulation or nerve blocks
    • Surgery
  • Prevention

    There are no current guidelines to prevent vulvodynia.
  • RESOURCES

    The American Congress of Obstetricians and Gynecologists http://www.acog.org

    National Vulvodynia Association http://www.nva.org

    CANADIAN RESOURCES

    Canadian Women's Health Network http://www.cwhn.ca

    Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

    References

    ACOG Practice Bulletin No. 93: diagnosis and management of vulvar skin disorders. Obstet Gynecol. 2008;111:5):1243-1253.

    What is vulvodynia? National Vulvodynia Association website. Available at: http://www.nva.org/whatIsVulvodynia.html. Accessed June 26, 2013.

    Vulvodynia. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/vulvodynia.html. Updated August 2010. Accessed June 26, 2013.

    Vulvodynia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 25, 2013. Accessed June 26, 2013.

    Vulvodynia. National Institute of Child Health & Human Development website. Available at: http://www.nichd.nih.gov/health/topics/vulvodynia/Pages/default.aspx. Updated April 3, 2013. Accessed June 26, 2013.

    4/7/2014 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Reed BD, Legocki LJ, et al. Factors associated with vulvodynia incidence. Obstet Gynecol. 2014;123(2.1):225-231.

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