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Vulvodynia/Vestibulodynia
- Chronic vulvar pain with an unknown cause
- The location and severity of pain can vary among sufferers
- Some women will experience pain in one area of the vulva, while others will experience pain in multiple areas
- 2 main subtypes
- Localized Vulvodynia: Pain experienced at only one vulvar site
- Provoked Vestibulodynia (PVD): Pain limited to the vestibule occurring before/after pressure is applied to the vestibule ie: sexual intercourse, gynecologic exams, tampon insertion, sitting for extended periods of time, wearing tight pants
- Vestibulodynia: Pain in the vestibule (the tissue surrounding the vaginal opening)
- Clitorodynia: Pain in the clitoris, less common form of localized vulvodynia
- Generalized Vulvodynia
- Pain can occur spontaneously and can be fairly constant, although there can be periods of relief from symptoms
- Activities that apply pressure to the vulva can often make symptoms worse ie: sexual intercourse, sitting for extended periods of time, wearing tight pants
- Some women may experience pain in a specific area while others can experience pain in multiple areas even including the perineum and inner thighs
- Localized Vulvodynia: Pain experienced at only one vulvar site
- Researchers speculate that one or more of the following may cause/contribute to the condition:
- Pelvic floor dysfunction
- Past vaginal infections
- Allergies/sensitive skin
- Hormonal changes
- Injury/irritation of the nerves surrounding the vulvar region
- Increase in sensitivity of pain-sensing nerve fibres in the vulva
- Abnormal vulvar cell response to environmental factors such as infection/trauma
- Genetic susceptibility to chronic vestibular inflammation, chronic widespread pain and/or inability to fight infection
- Pain/burning near the opening of the vagina, and sometimes only when something touches that area
- Pain on/around the vulva, even when nothing touches that area
- Burning/Stinging
- Itching
- Swelling
- Throbbing
- Rawness
- Painful intercourse (dyspareunia)
- Flares up during and after sexual intercourse, wiping, sitting on a bicycle or inserting a tampon
- Medical, sexual and surgical history and symptom evaluation
- Vaginal exam: Vulva, vagina and vaginal secretions are checked to rule out an infection/skin disorder
- Blood test: To assess hormone levels
- Cotton-swab test: To gently check for specific, localized areas of pain in your vulvar region
- Oral Medications:
- Pain medications: Steroids, tricyclic antidepressants, anticonvulsants
- Antihistamines: To reduce itching
- Topical Medications
- Hormonal creams
- Local anaesthetics: Lidocaine
- Compounded formulations
- Discontinuation of irritants (ie: laundry detergent, soaps, etc)
- Pelvic Floor Physiotherapy
- Biofeedback Therapy: Teaching you how to relax your pelvic muscles and control how your body responds to the symptoms
- Nerve Blocks
- Surgery: To remove the affected skin and tissue (vestibulectomy) in cases of localized vulvodynia or vestibulodynia
