Vulvodynia is a chronic pain condition affecting the vulva, the area on the outside of a woman’s genitals. It lasts more than three months and has no clearly identifiable cause, such as an infection or a skin disorder.
This pain may lead to sexual dysfunction and negatively impact quality of life.
At Viva Health, board-certified OB/GYN Dr. Aleksander J. Bodnar and his staff treat all manner of gynecological conditions, including vulvodynia. Since the warning signs of this condition can mimic other issues, it’s important you understand what the problem is and how we can treat it.
The causes of vulvodynia
Researchers have come up with a number of suspected causes, but the truth is their knowledge about the cause is limited. Suspects include inflammation, injury to nerves in the area (neuropathic problems), hormonal factors, musculoskeletal issues, and genetic factors.
Women with vulvodynia often suffer from other common pain conditions, such as painful bladder syndrome, fibromyalgia, irritable bowel syndrome (IBS), and temporomandibular disorder (TMJ).
Symptoms and 3 warning signs of vulvodynia
The symptoms of vulvodynia can mimic other conditions. The primary symptom is pain in your genital area, which can present as burning, soreness, rawness, throbbing, or stinging.
The pain might be constant, pop up only occasionally, or occur only when the sensitive area is touched. You might feel the pain throughout the vulvar area (generalized), or it might affect a specific area, such as the opening of your vagina (vestibule).
A second symptom is painful intercourse, or the inability to have sex because of the pain.
A third symptom can be redness or inflammation of the vulvar tissue, but many times the tissue appears normal.
Many women are hesitant to talk about the problem with their doctor, but it’s important you get an accurate diagnosis to receive effective treatment.
Dr. Bodnar can confirm or rule out more easily treatable causes of vulvar symptoms, such as yeast or bacterial infections, herpes, precancerous skin lesions, genitourinary syndrome of menopause, and medical problems such as diabetes.
Vulvodynia treatments focus on relieving your pain and other symptoms. No single treatment works in every case, so Dr. Bodnar may combine treatments to get a satisfactory result. It can take time to find the right treatment, and it can take time after starting treatment to feel relief.
Treatment options include:
Drugs that include steroids, tricyclic antidepressants, and anticonvulsants can all help lessen chronic pain, while antihistamines can reduce itching.
This therapy reduces pain by teaching you how to relax your pelvic muscles and exert control over how your body responds to symptoms.
Local anesthetics/topical medications
Anesthetics applied topically, such as lidocaine ointment, can provide temporary symptom relief. If you experience painful intercourse, Dr. Bodnar might recommend applying the lidocaine 30 minutes beforehand to reduce discomfort.
Nerve blocks silence the nerves sending pain signals to the brain. If you have long-standing pain that doesn't respond to other treatments, you might benefit from local nerve block injections.
Pelvic floor therapy
Another symptom of vulvodynia is tension in the pelvic floor muscles, which support the uterus, bladder, and bowel. Exercises designed to relax those muscles can help relieve pain.
If you have localized vulvodynia or vestibulodynia, surgery that removes the affected skin and tissue (vestibulectomy) can sometimes relieve the pain.
Living with chronic vulvar pain can affect a woman’s sexual relationship and lead to anxiety and/or depression. You may find it beneficial to see a psychologist or a couples/sex therapist.
Cognitive behavioral therapy (CBT), which teaches you to respond to negative stimuli in healthier ways, may also help.
If you’re experiencing chronic vulvar pain, don’t be embarrassed or ashamed to discuss it with Dr. Bodnar; he can help. To schedule a consultation, call Viva Health in Clifton or Linden, New Jersey, or book online today.