• 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
    Copyright © Nucleus Medical Media, Inc.

    Causes

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

    Risk Factors

    Vulvodynia is more common in women who are younger. Other factors that may increase the chance of vulvodynia include:
    • History of vulvodynia
    • Chronic pain or disorders associated with chronic pain
    • Sleep disturbances
    • Some mental health disorders, such as posttraumatic 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

    You will be asked 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 fluids and tissues may need to be tested. This can be done with:
    • A swab of the vaginal area
    • Biopsy

    Treatment

    Talk with your doctor about the best treatment plan for you. Options include:

    Medications

    Medications may include:
    • Topical medications that are applied to the skin, such as corticosteroids, estrogen, or anesthetics
    • Antidepressants
    • Anticonvulsants
    • Prescription pain relievers

    Physical Therapy

    Therapy can help strengthen and relax the pelvic muscles. This will ease muscle spasms. A referral to a doctor who specializes in pelvic floor issues may be needed.

    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. Reaffirmed 2013.

    Vulvodynia. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/vulvodynia.html. Updated April 2014. Accessed June 8, 2016.

    Vulvodynia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 27, 2016. Accessed June 8, 2016.

    Vulvodynia. National Institute of Child Health and Human Development website. Available at: http://www.nichd.nih.gov/health/topics/vulvodynia/Pages/default.aspx. Updated April 22, 2013. Accessed June 8, 2016.

    What is vulvodynia? National Vulvodynia Association website. Available at: http://www.nva.org/what-is-vulvodynia. Accessed June 8, 2016.

    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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