* 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 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
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 lighted magnifying instrument
* Biopsy —removal of a sample of tissue for testing
Talk with your doctor about the best treatment plan for you. Treatment options include:
Topical anesthetics (eg, lidocaine, xylocaine), estrogen creams, and corticosteroid creams can be used to help manage pain. Sometimes injections of steroid into the skin (combined with local anesthetic) may be used. In addition, there is some evidence that tricyclic antidepressant medications (eg, amitriptyline, nortriptyline, and desipramine) can relieve pain and irritation. Other medications such as Neurontin, Cymbalta, and Lyrica are sometimes tried.
Last reviewed May 2007 by Jeff Andrews, MD, FRCSC, FACOG
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