Health Encyclopedia | Butler Hospital Providence, RI

Vulvodynia

Definition

Vulvodynia is chronic pain or discomfort in the vulva. The vulva is often called the lips of the vagina. The vulva includes:

Labia (labia majora and labia minora)
Clitoris
Vaginal opening

Female Genitalia

Causes

The causes of vulvodynia are not completely known but may include:

Infection
Changes in the vulvar tissue
Perhaps abnormal nerve sensation

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors are thought to increase the risk of vulvodynia:

Recurrent yeast infections
Frequent use of antibiotics
Irritation to the genitals by soaps or detergents
Genital rashes
Previous treatment or surgery to the external genitals
History of genital warts
Pelvic nerve irritation or muscle spasms
History of sexual abuse
History of domestic violence

Symptoms

Symptoms of vulvodynia may include:

Pain of the vulva, which may come and go
Burning of the vulva
Stinging of the vulva
Irritation of the vulva
Rawness of the vulva

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:

Pelvic exam
Tests to check for bacteria and/or yeast
Magnified exam, using a colposcope—visual examination of the vulva and vagina using a low-power microscope
Biopsy —removal of a sample of tissue for testing

Treatment

Talk with your doctor about the best plan for you. Treatment options include:

Medications

To help manage pain:

Topical anesthetics (eg, lidocaine , xylocaine)
Estrogen creams
Corticosteroid creams
Injections of steroid into the skin—may be used

For pain and irritation relief:

Tricyclic antidepressant medications—research has shown a potential effect

Other medications that are sometimes tried include:

Physical Therapy

Therapy can help you strengthen and relax your pelvic muscles. This will ease muscle spasms. You will need to see a specialist in pelvic floor issues.

Other Treatments

Suggested treatments for vulvodynia include:

Interferon injections
Laser treatments
Surgery

Prevention

The causes of vulvodynia are not well-understood. There is no known way to prevent.

RESOURCES:

American College of Obstetricians and Gynecologists
http://www.acog.org/publications/patient_education/

National Vulvodynia Association
http://www.nva.org/

National Women's Health Information Center
http://www.4woman.gov/

New York Center for Vulvovaginal Pain
http://www.vulvodynia.com/

CANADIAN RESOURCES:

Canadian Women's Health Network
http://www.cwhn.ca/

Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org/

References:

About vulvodynia. National Vulvodynia Association website. Available at: http://www.nva.org/about_vulvodynia/what_is_vulvodynia.html. Accessed April 20, 2007.

Vulvodynia. American Academy of Family Physicians website. Available at: http://familydoctor.org/367.xml. Accessed April 20, 2007.

Vulvodynia. National Institute of Child Health & Human Development website. Available at: http://www.nichd.nih.gov/health/topics/Vulvodynia.cfm. Accessed April 20, 2007.

Last reviewed January 2009 by Ganson Purcell Jr., MD, FACOG, FACPE

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.