Listen as Dr. Pukall discusses what causes vulvodynia pain. Dr. Caroline Pukall is an Assistant Professor in the Department of Psychology at Queen’s University in Kingston, Ontario, Canada.
Dr. Pukall and Todd Hartley:
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Todd Hartley:
I’m joined right now by Dr. Caroline Pukall, the assistant professor at the Department of Psychology at Queen’s University in Kingston, Ontario, Canada. Dr. Pukall, thank you for joining us on The Empower Network.
Dr. Pukall:
Thank you very much for having me.
Todd Hartley:
What causes vulvodynia pain?
Dr. Pukall:
Well, we don’t really know what causes the pain of vulvodynia, and when we talk about vulvodynia I have to make it clear that there are different sub-types of vulvodynia or chronic vulvar pain. The two most common ones are something called vestibulodynia; this was formerly known as vulvar vestibulitis syndrome, and this typically affects about 12% of premenopausal women in the general population. There is another type that is quite common called generalized vulvodynia, and this typically affects 6% to 7% of women in the general population, typically over the age of 30. Now, I’ll be very honest with you;, we do not know what causes the pain of these types of vulvodynia. Essentially in the vestibulodynia literature, there has been a lot of research looking at what could potentially cause this pain. We do not know but there seems to be some evidence that the early use of oral contraceptive pills can increase your chances of developing this pain later in life, and this is likely due to a hormonal component although we’re not exactly sure what that mechanism can be. There is also some evidence supporting the fact that a history of repeated yeast infections or candida infections can increase the risk of developing this pain later in life as well. We do not know whether it is the yeast itself, treatments undertaken to treat the yeast infections, or something else that is co-occurring with the yeast infection, and I must also hasten to add that these two factors are not necessary and sufficient in order to develop vestibulodynia. So there will be plenty of women that I will see who have never been on an oral contraceptive pill or who have never had a history of repeated yeast infections or maybe have had just one or two in the past five years. And so, these factors seem to increase the risk but they are not determining factors; there are other factors that play. Now we know a lot less about the generalized vulvodynia subtype of vulvar pain. So we don’t really know what causes it, but it seems to be some kind of neuropathic pain process which seems to really fall along sort of neuropathic pains which are described as burning. and the pain is quite constant, and sometimes if you touch the area the pain can become quite worse, and we are not really sure what can cause that. Sometimes women may report that having undergone some kind of surgery in their abdominal area, sometimes having had vaginal delivery, sometimes an injury of some sort can actually lead to the pain, but once again, most of the time the pain just kind of starts innocuously and develops into this chronic pain syndrome, so we are not entirely sure.
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For more information on Dr. Caroline Pukall visit Queen's University in Kingston, Ontario, Canada.