Vulvodynia


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What is my vulva and why is it important?

The vulva, which is the area between your thighs, has 5 parts: the mons pubis, labia majora and labia minora, clitoris, urinary opening (opening to the urethra), and vaginal opening. The mons pubis is the tissue and skin that is covered in pubic hair. It protects the pubic bone and the rest of the vulva. The labia majora and labia minora are the outer and inner lips that cover the vaginal opening and the urinary opening. The clitoris, which is a woman's sexual organ, is just above the urinary opening.

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What is vulvodynia?

Vulvodynia is chronic pain of the vulva when no other cause is found. This pain can feel like stabbing, stinging, burning, or irritation. Each woman feels the pain differently. For some women, the pain is in just one area of the vulva. Others have pain in several places. Some women have pain only when pressure is applied to the vulva like during sex or putting in a tampon. Others have pain that happens on its own. These women may have pain that is worse with activities that put pressure on the vulva like sitting and wearing pants.

What causes vulvodynia?

We do not know for sure what causes vulvodynia. Some believe it is a problem with the nerves around the vulva. Others think it has to do with the way your body responds to pain. Researchers continue to search for the exact cause.

What should I do if I think I have vulvodynia?

If you have pain in your vulvar area, you should see a health care provider to discuss this. Your provider will ask about your medical history and the pain you are having. A complete pelvic examination will be done to check the health of your vulva and try to find a cause of your pain. Your provider may perform a test where a cotton swab is used to put gentle pressure on different areas of your vulva. This gives your provider a better idea of where your pain is and how bad it hurts.

What lifestyle changes can I make to help with my vulvodynia?

Some changes in the way you care for your vulva may help you have less pain:

  • • Avoid things that may irritate your vulva like soaps, shampoo, perfumes, douches, bubble baths, and scented pad or tampons.
  • • Wash your vulva with warm water and pat it dry with a sof towel.
  • • Wear 100% cotton underwear with loose fitting pants or skirts.
  • • Do not use traditional lubricants during sex. Instead use natural vegetable oils like olive oil.

For more details on how to care for your vulva and keep it healthy, see the Share with Women handout on vulvar care at http://www.sharewithwomen.org.

What is the treatment for vulvodynia?

Unfortunately, there is no cure for vulvodynia. But, there are treatments that can help you have less pain. Treatment is often decided on by trial and error because we do not yet know what the best treatments for vulvodynia are.

  • • Pain relief cream, such as lidocaine jelly, can be used to numb the painful areas. These creams can cause stinging and numbness in your partner's penis. You should not use them during oral sex.
  • • Oral medicines that are used to treat depression or seizures also can be used to treat vulvodynia.
  • • Physical therapy can help relax your pelvic floor muscles, which can make your pain better.
  • • Some alternative therapies like acupuncture and hypnosis may be useful.
  • • As a last resort, surgery can be used for women who do not respond to other treatments. Different types of surgeries remove different parts and amounts of the vulva. Most women are satisfied with their pain relief after surgery. Surgery can cause bleeding, infection, sensitive scar tissue, decreased lubrication, and a change in the appearance of the vulva.

How do I cope with the pain?

Having this type of pain can be very stressful for you and your partner. Depression, anxiety, and hopelessness are common for women with vulvodynia. If you feel this way, you are not alone. Going to counseling can help you deal with these feelings better and can help with your pain and sexual function. It may be helpful for your partner to go to counseling with you.

For More Information

National Vulvodynia Association

http://nva.org

Vulval Pain Society

http://www.vulvalpainsociety.org

American Physical Therapy Association

http://www.apta.org/

The “Find a PT” tab will allow you to search for a women's health physical therapist.

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