Vulvodynia

Vulvodynia describes a condition of vulval pain and or soreness in the absence of any skin condition. Remember the vulva, refers to the external female genital organs, which includes the labia, clitoris, and vaginal opening.

The pain can be experienced in very different ways by individuals. It may be localised to one area e.g. clitorodynia (pain at the clitoris) or generalised over the whole vulva and spreading into legs, upper thighs or around the anus. Some patients will have mixed pain, that is localised and generalised.

In some patients the pain will be described as ‘provoked’ when contact causes the pain this is reffered to as vestibulodynia; in others pain may be spontaneous and occur without an apparent trigger. Some patients will be familiar with both spontaneous and provoked pain. The onset of the pain may have been the first symptom in some patients, which is described as primary; in others the pain will be a secondary symptom perhaps following another illness or event.

The times pain is experienced will also differ between women, in some it may be intermittent in others persistent.

Symptoms of vulvodynia usually begin suddenly and can last anywhere from months to years. These symptoms can include:

Burning sensation
Stinging or rawness
Painful sex (Dyspareunia)
Aching, soreness, or throbbing

The intensity of the pain can range from mild discomfort to severe constant pain that prevents you from even sitting comfortably.
Although there is nothing to see on examination the condition is caused by hypersensitivity of the nerves around the vulva. The experience of the pain can cause a secondary protective spasm of the muscles of the pelvic floor resulting in a further pain cycle. In the majority of cases the pain has no known cause, in some patients the onset of the pain may be linked to:

•     Nerve injury or irritation
•     Abnormal response to an infection or trauma
•     Genetic factors
•     Hypersensitivity to yeast infections
•     Muscle spasms
•     Allergies or irritation to chemicals or other substances
•     Hormonal changes
•     Sexual abuse
•     Frequent antibiotic use

Many health care providers may not be familiar with Vulvodynia.  Women suffering from Vulvodynia  should look for a doctor, sex therapist or physiotherapist that is knowledgeable about this condition. Although there is no cure, there are treatments that can help bring relief. Use of high quality lubricants, vaginal dilators or therapeutic aids for massage may be recommended by your physiotherapist or healthcare practitioner which can help women learn to relax vaginal muscles to lessen pain.