Summary about Disease
Vulvovaginal pain, also known as vulvodynia, is chronic pain in the vulva (the external female genitals) that lasts for at least three months. It's not an infection, and the cause is often unknown. It can significantly impact a woman's quality of life, affecting sexual activity, relationships, and overall well-being. Different types exist, including localized provoked vulvodynia (pain with touch, like during intercourse) and generalized vulvodynia (pain in multiple areas, sometimes without any trigger).
Symptoms
Burning, stinging, or raw pain in the vulva.
Throbbing or aching pain.
Itching.
Pain with touch or pressure (e.g., intercourse, tampon insertion, sitting).
Pain that is constant or intermittent.
Redness or swelling (less common).
Causes
The exact cause of vulvodynia is often unknown. However, potential contributing factors include:
Nerve damage or irritation.
Genetic factors.
Hypersensitivity to yeast infections.
Changes in hormone levels.
Pelvic floor dysfunction (muscles that support the pelvic organs).
Inflammatory conditions.
Psychological factors, such as anxiety or depression, can exacerbate the pain.
Medicine Used
Treatment for vulvodynia often involves a combination of approaches:
Topical medications: Lidocaine cream (a local anesthetic), corticosteroids (to reduce inflammation), or estrogen cream (if low estrogen is a factor).
Oral medications: Tricyclic antidepressants (amitriptyline, nortriptyline) and SNRIs (duloxetine, venlafaxine) to manage nerve pain, anticonvulsants (gabapentin, pregabalin) for nerve pain.
Nerve blocks: Injections of local anesthetics to block pain signals.
Pelvic floor physical therapy: To strengthen and relax pelvic floor muscles.
Biofeedback: To help control muscle tension and pain.
Cognitive behavioral therapy (CBT): To help cope with chronic pain and improve quality of life.
Is Communicable
No, vulvodynia is not contagious or communicable. It is not caused by an infection that can be spread to others.
Precautions
Avoid irritants: Use unscented soaps, tampons, and detergents. Avoid douching or using feminine hygiene sprays.
Wear cotton underwear: Avoid tight-fitting clothing and synthetic materials.
Use lubricants during intercourse: Choose water-based or silicone-based lubricants.
Avoid prolonged sitting: Use a donut cushion to reduce pressure on the vulva.
Manage stress: Practice relaxation techniques, such as yoga or meditation.
Maintain good hygiene: Gently wash the vulva with water and mild soap.
Avoid harsh chemicals: These can irritate the sensitive skin.
How long does an outbreak last?
Vulvodynia is a chronic condition, meaning it lasts for at least three months. It's not an "outbreak" like a herpes outbreak. The pain can be constant, intermittent, or cyclical. Symptoms may fluctuate in intensity over time. The duration of symptoms varies significantly from person to person and depends on the effectiveness of treatment.
How is it diagnosed?
Diagnosis of vulvodynia typically involves:
Medical history: The doctor will ask about your symptoms, medical history, and sexual history.
Physical exam: A visual examination of the vulva to rule out other conditions.
Q-tip test (cotton swab test): Gentle touch of different areas of the vulva with a cotton swab to identify areas of pain.
Pelvic exam: To assess the pelvic floor muscles.
Ruling out other conditions: Tests may be done to rule out infections, skin conditions, or other causes of vulvar pain.
Timeline of Symptoms
There isn't a specific timeline, as vulvodynia presents differently in each individual. However, the general pattern is:
Onset: Gradual or sudden onset of vulvar pain.
Progression: Pain may initially be mild but can worsen over time.
Fluctuation: Pain may fluctuate in intensity, with periods of remission and exacerbation.
Chronic: Pain persists for at least three months and can last for years if untreated.
Triggered vs. Unprovoked: Pain can be triggered by touch, pressure, or intercourse, or it can occur spontaneously without any apparent cause.
Important Considerations
Seek medical attention: If you experience persistent vulvar pain, it's important to see a healthcare provider for diagnosis and treatment.
It can impact Mental health: The chronic pain can lead to mental health problems.
Be patient: Finding the right treatment plan can take time and experimentation.
Communicate with your partner: Vulvodynia can affect sexual intimacy, so open communication with your partner is crucial.
Support groups: Joining a support group can provide emotional support and connection with others who have vulvodynia.
Specialist: A gynecologist or other specialist with expertise in vulvar pain can be helpful.
It is NOT "all in your head": This is a real medical condition that requires proper diagnosis and management.