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Vulvodynia Symptoms & Treatment

Vulvodynia means “pain of the vulva” but it is defined by the International Society for the study of Vulvovaginal Disease as chronic vulvar discomfort or pain which can be characterized by burning, stinging, irritation or rawness of the female genitalia.

The cause of Vulvodynia is still unknown and is speculated by physicians to be caused by an injury or irritation of the nerves that supply and receive signals from the vulva, a localized super sensitivity to yeast, an allergic reaction to environmental irritants, high levels of oxalate crystals in the urine, and spasms or irritation of the pelvic floor muscles. At this time, there is no evidence that Vulvodynia is caused from any type of infection or a sexually transmitted disease.

Vulvodynia has different symptoms but the most common is a burning sensation. The type and severity of the symptoms differ from each woman. Some complain of stinging, irritation or rawness. It can be constant or intermittent, localized or diffused. There are two major subsets of Vulvodynia and are very much different.

One is Dysesthetic Vulvodynia which can be present in the labia majora and or the labia minora. It can affect the clitoris, perineum, mons pubis and even the inner thighs. The pain can either be constant or intermittent and is not always associated by touch or pressure to the area. Sometimes, the vulvar area may show signs of inflammation but normally there are no visible signs.

The other subset is Vulvar Vestibulitis and is associated with pain when touched or pressure is applied to the area around the opening of the vagina. Pain is noted with intercourse, tampon insertion, gynecologic exam, bicycle riding, horseback riding and even the wearing of tight clothing such as pantyhose or jeans. Usually the area around the vagina is inflamed and red.

With both subsets of Vulvodynia the pain can be very severe and can limit a woman’s ability to function normally. Many women with Vulvodynia have had to resign from employment, stop all sexual relation, even limit their shopping or walking due to the extreme pain.

The first thing to do is to seek medical attention. The physician will first rule out any other conditions that may cause this type of pain including sexually transmitted diseases, infections, skin disorders and human papillomavirus. A culture is usually taken to rule out any of these other causes. The next step will then be to use a Q-tip and touch the different areas of the vulva and vestibule to determine the location and how severe the pain is in those areas. If your doctor during the exam notices any areas of the skin that look abnormal or suspicious he may want to perform a biopsy or a colposcopy. A colposcopy is a procedure that uses a special instrument to better exam the vulva.

There are some treatments available for Vulvodynia but remember very few cases are ever cured but these treatments can provide some relief from the pain and may even completely rid you of the pain. It may take awhile to find the best treatment for each woman since the severity of the pain is different each woman. The treatments that are currently being used include anti-inflammatories, antihistamines, lidocaine, tricyclic antidepressants, anticonvulsants, interferon injections, topical estrogen cream, surface electromyography, low oxalate diet with calcium citrate, and in the case of severe vulvar vestibulitis syndrome surgery may become necessary.

There are a few self help remedies or home remedies that can provide some relief and may even prevent new flare ups or the increase in symptoms. The best recommendations are to wear only cotton underwear and loose clothing. Instead of wearing pantyhose try using stockings. During sex, if you must use a lubricant do not use any that contain preservatives or chemicals. Use such lubricants as almond oil, vegetable oil, or lubricants with glycerin. Apply these at the beginning of sexual intercourse, since being touched is also as painful as the sexual act. Use only white or unbleached toilet tissue and all female sanitary products should be 100 percent cotton fiber. When you buy new underwear always wash before wearing and make sure you rinse out all of the soap residue. Do not use fabric softener liquids or dryer sheets with your undergarments. Try not to use any perfumed creams, soaps, Vaseline, oils, lanolin, bubble bath, bath oils or so-called "feminine deodorant" products. After urinating, spray the vulva area with clear water from a squeeze bottle this may reduce the burning sensation. Baking soda can also be used temporarily to reduce pain. Aveeno compresses can be used three to four times a day to also soothe the burning and stinging. Do not use contraceptive devices and creams that may irritate. Do not sit in a wet bathing suit.

You should also talk with your doctor. If sexual intercourse is extremely painful he can give you a prescription for Xylocaine which is a topical ointment. Many women have stated this ointment does help make sexual activity more comfortable.

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