Vulvodynia

Description, Causes and Risk Factors:

Alternative Name: Pain of the vulva.

The vulva is the external part of the female genitalia. The outer and inner lips of the vulva are called the labia majora and labia minora. The vestibule surrounds the opening of the vagina and the urethra. The openings to the Skene's and Bartholin's glands are located within the vestibule. The perineum is the area between the bottom of the vulva and the anus.

Vulvodynia is a condition in which the female genitals begin experiencing pain. This pain could be from mild to severe, depending on the nature of the condition. In some women, the pain is experienced as a burning sensation, which is typically felt when they are passing urine. The pain can also be a stinging kind of pain, which can make life very difficult for the woman that has this condition. Vulvodynia is an exclusively female condition, and it can be a consequence of several reasons.

Types may include:

Generalized or dysesthetic vulvodynia.

• Vulvar vestibulitis syndrome.

• Cyclic vulvovaginitis.

• Vulvar dermatoses.

The incidence of vulvodynia is not known but it is clearly more common than is generally thought. In a general gynecological practice the prevalence can be as high as 15% when actively looked for. Characteristics of the patients with vulvodynia are nonspecific. The age distribution ranges from mid-20s to late 60s. Often, women with vulvodynia do report depression, but it is just as easily a result of the condition as it is a cause.

A host of causes can be responsible for the condition of vulvodynia. The following is a list of some of them.

Infections of the vagina.

• Certain skin conditions, such as allergies.

• Some injury to the vaginal area.

• Hormonal imbalances, especially that of estrogen.

• Some physical factors may also cause the condition. Women who cycle a lot, wear tampons more frequently, are highly sexually active and have a lot of sitting to do in their day can develop this condition more frequently than those who do not have such a kind of a lifestyle.

Many women try to ignore the condition because of the embarrassment that is associated with mentioning the problem to a physician. Some women will wait till the pain becomes unbearably severe before they visit the doctor. Also, there is the point that there are no external symptoms associated with vulvodynia, because of which women do not think something is wrong with them at all, despite the pain that they experience.

Symptoms:

The most common symptoms are burning, stinging, irritation, aching or rawness of the genital area. The pain may be constant or it may only occur intermittently - when the vulva is touched, for example. The pain may also be felt around the urethra, back passage, tops of the legs and inner thighs.

Each woman can have different symptoms, with varying degrees of severity.

As with most chronic pain conditions, vulvodynia adversely affects quality of life, not only can it prevent women from engaging in and enjoying sexual activity, but daily activities may also be impaired. Some women with vulvodynia are unable to exercise or feel difficulty to drive. For some, even sitting becomes a challenge.

When a condition has a detrimental impact on work, family and social life, low self-esteem, poor self-image and depression often develop. This can exacerbate the symptoms, dragging the woman into a negative downward spiral.

Diagnosis:

To diagnose Vulvodynia, medical specialists will carefully review your medical history. You will be asked questions aboutyour symptoms, sexual activity, diet, feminine hygiene, previous medical problems and medication use. Your doctor shouldalso carefully examine the vulva, vagina and any vaginal secretions for other causes of your pain such as infections and skindisorders. Many doctors will perform routine fungal vaginal cultures to ensure that an infection is not causing or worseningany irritation or burning.

A "q-tip test" may be administered during your exam. During this test, different areas of the vulvaand vestibule are touched with a Q-tip to determine the location and severity of your pain. If your doctor sees areas of skinthat look suspicious during your exam, a biopsy of the skin may be required. Additionally, he/she may look more closelythrough a magnifying glass at any abnormal lesions in the vulva or may recommend a colposcopy, a test in which aninstrument is used to look at the vulva more closely.Additionally, physicians may recommend a colposcopy, a procedure that uses a specialized instrument to examine the vulva more closely.

Treatment:

The treatment depends on the cause of your vulvodynia. Some types of vulvar pain get better with creams or pills made to treat yeast infections. Sometimes the pain goes away if you use creams that contain estrogen or cortisone, but cortisone cream is not good to use for long periods of time. Some antidepressant medicines can help nerve pain and irritation. Other treatments that may help include interferon injections, laser therapy or surgery.

Muscle spasms in your pelvic area can also make vulvar pain worse. Physical therapy or biofeedback treatments (treatments that help you strengthen and relax your pelvic muscles) may help ease the spasms. If you decide to try one of these treatments, look for a therapist trained in women's health. With practice, you can learn to relax your pelvic muscles with exercises you do at home.

Risk and benefits of the treatment must be discussed with your PCP.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.