Vulvodynia

Definition

Definition

Vulvodynia is chronic pain or discomfort of the vulva. The vulva includes the:

  • Labia majora and labia minora
  • Clitoris
  • Vaginal opening

Female Genitalia

Copyright © Nucleus Medical Media, Inc.

Causes

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

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 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

Symptoms may include:

  • Pain, which may come and go
  • Burning
  • Stinging
  • Irritation
  • Rawness

Diagnosis

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.

Testing may include:

  • Tests to check for bacteria and/or yeast
  • Biopsy

Treatment

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

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.

What is vulvodynia? National Vulvodynia Association website. Available at:
http://www.nva.org/what-is-vulvodynia
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 and 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, Plegue MA, Sen A, Haefner HK, Harlow SD. Factors associated with vulvodynia incidence. Obstet Gynecol. 2014;123(2.1):225-231.

Last reviewed June 2015 by Andrea Chisholm, MD
Last Updated: 4/7/2014

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