Understanding Vulvodynia: Common Myths vs. Facts

A chronic pain condition affecting the vulva is known as vulvodynia. There is no known cause, and it typically lasts longer than three months. It’s difficult to determine how common vulvodynia is despite the fact that it’s the main cause of uncomfortable sex for women who haven’t had menopause. It is a frequent medical disorder that affects women and causes sudden pain around the vulva or vagina. Vulvodynia is a common occurrence for women at some point in their life. Vulvodynia illness might last for three months or longer in certain cases.  

What is vulvodynia?

Vulvodynia is a persistent, unexplained discomfit in the vulva, vagina or genitalia. Common signs of a number of illnesses, such as infections and skin problems, include vaginal and vulvar pain. Pain that lasts three months or longer and isn’t a clear sign of a particular illness is indicative of vulvodynia. You may be unable to engage in enjoyable activities because of how exhausting the pain can be.  

What are the types of vulvodynia?

There are mainly two types of vulvodynia:

Localised vulvodynia: Pain is typically localised to one area, such as your clitoris or vulvar vestibule. The skin between your inner labia, or vaginal lips, and the urethral and vaginal openings is known as the vulvar vestibule. The little, bead-like organ at the apex of your vulva is known as the clitoris. Localised vulvar pain syndrome is another name for localised vulvodynia.  

Generalised vulvodynia: There are instances when the discomfort is not localised. Rather, you can have pain at different times. You may feel pain throughout your vulva. Vulvodynia could be provoked and unprovoked. In cases of provoked vulvodynia, one will experience pain when touched or while performing activities; however, with unprovoked type, pain is not associated with these factors.  

How does vulvodynia affect a person’s life?

Vulvodynia can be stressful and life-threatening. It affects and causes:

• Pain from sitting for too long can make it challenging and painful
• The difficulty or impossibility of sexual intercourse, which can damage relationships
• Harder time falling and staying asleep
• Limited clothing options

Vulvodynia symptoms  

Different people experience vulvodynia pain in different ways. It also differs from person to person when the pain begins, ends or feels the worst. It causes symptoms like:

• Burning
• Stinging
• Stabbing
• Itching
• Rawness
• Throbbing  

What are the causes of vulvodynia?

The exact causes of vulvodynia are unknown, but the potential factors that lead to these conditions include:  

• Inflammation
• Hormonal factors
• Genetic factors
• Injury to the nerves
• Long-term reactions to past vaginal infections
• Weakened pelvic floor muscles or muscle spasm
• Irritation from harsh products that touch the skin area

Diagnosis of vulvodynia

Vulvodynia is diagnosed by ruling out other conditions that may be causing the pain. The various diagnostic procedures for vulvodynia include:

• Physical examinations: Physical examination like a pelvic exam with a speculum to assess the vagina and cervix. The provider will evaluate the pelvic floor muscles to identify painful areas.  
• Cotton swab test: It is also known as point-pressure testing. A cotton swab is gently brushed over the parts of the vulva where the contact feels painful. This test is especially helpful for diagnosing localised pain in the vulvar vestibule.  
• Swabs to test for infections: This test rules out conditions that may cause vulvar pain, like sexually transmitted infections, bacterial vaginosis and yeast infections.  
• Biopsy: Biopsy is a method of diagnosis by taking samples of tissue or fluid and studying them under a microscope to look for cancer cells and determine the kind of cancer. It is also tested for genetic changes called mutations.

Vulvodynia treatment  

Vulvodynia takes a lot of time to recover. Identifying the treatment or combination of treatments that bring you pain relief involves trial and error. Treatment takes time to work, and it may not always provide immediate relief. There are various treatment options for vulvodynia, including:  

• Topical medications: Topical medications like creams and ointments numb the vulva or stabilise the nerves. A provider may also prescribe topical creams that contain oestrogen or a mix of oestrogen and progesterone.  
• Oral medications: Oral medications like antidepressants and anticonvulsants can be taken by mouth, which reduces nerve pain.
• Nerve block injection: An injection that prevents pain signals from travelling from the nerves to the brain and relieves nerve blocks.  
• Physical therapy: Physical therapy can loosen muscle tension in the pelvic floor, such as in muscles, ligaments and connective tissue in the pelvic region. It may also reduce how often the pelvic floor muscles spasm. Muscle spasms are common with vulvodynia. Treatments may involve stretching, lengthening and strengthening weak pelvic floor muscles.  
• Vestibulectomy: This surgery can be helpful for people with localised vulvodynia whose pain has not improved with more conservative treatments. In this treatment, a healthcare provider removes tissue in the part of the vulva that feels painful.  
• Counselling: Individual counselling and sex therapy help improve the areas that are negatively impacted by vulvodynia.  

Can anxiety cause vulvodynia?

Anxiety and stress can affect how pain is perceived and may cause tense muscles or other physiological changes that exacerbate pre-existing disorders. Anxiety can also impair a person’s general health and capacity to manage pain, which may exacerbate symptoms. For a thorough assessment and treatment plan, it’s critical to speak with a healthcare provider if you or someone else is exhibiting vulvodynia or similar symptoms. Depending on the needs of the patient, strategies may include counselling, medication, physical therapy or other therapies.  

• Preventive and managing methods of vulvodynia symptoms
• Take baths with Epsom salt or colloidal oatmeal.
• Use mild, unscented soap when washing the vulva.
• Use a mild, unscented soap when washing the vulva.
• Wear all cotton fabrics that come in contact with the vulva.
• Apply cold compresses or gel packs to the vulva.
• Use unscented or unflavoured lubricants during sex without cooling or warming effects.
• Get enough sleep each night.
• Incorporate stress reduction and relaxation techniques into everyday routine.  
• Avoid wearing tight-fitting clothes.
• Avoid using scented toilet paper.

Conclusion

To conclude, despite being the primary cause of uncomfortable sex for women who have not gone through menopause, the prevalence of vulvodynia, a chronic pain syndrome affecting the vulva with no known cause, is difficult to estimate. It usually lasts longer than three months.