Vulvodynia / Vestibulodynia
Vulvodynia is defined as vulvar discomfort or burning pain, occurring in the absence of relevant visible findings or a specific, clinically identifiable disease. It is estimated that as many as 14 million women in the United States may experience chronic vulvar pain during their lifetime. Unfortunately, at least 30% of these women will suffer without seeking medical care.
Vulvar vestibulitis syndrome is a type of vulvar pain which causes pain during vaginal penetration, including insertion of tampons or intercourse.
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The actual causes of vulvodynia can be elusive. Possible causes include abnormalities of embryologic development, genetic or immunologic factors, hormonal factors, nerve damage, allergic reactions, pelvic floor muscle tightening and nerve entrapment. It can lead to profound psychosocial issues.
Treatment is often multifaceted. Topical medications such as lidocaine, estrogen, testosterone, baclofen and gabapentin have been used successfully. Topical steroids and topical antifungals do not work for vulvodynia. Some antidepressants and medications that treat neuropathy have also been useful.
Physical therapy of the pelvic floor muscles is often used to decrease the tightness of the pelvic muscles.
It is important that a woman with vulvodynia or vestibulitis have a through evaluation by a health care provider familiar with all the causes of vestibular pain. There is not “one” cure for all vulvodynia patients.
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