Vulvodynia is a pain condition of the genitals that affects up to 15% of women. Most describe a burning pain, stinging, rawness, or irritation of the vulva (labia or lips) and/or the opening to the vagina (the vestibule). For some women the pain is present all of the time while others only have pain that is provoked by contact, either intercourse or non sexual contact such as inserting a tampon, sitting, or even the light touch of clothes.
Sadly, many women suffer in silence. Those who do have the courage to talk about their pain have to be persistent as more than half of them see at least three providers before getting the right diagnosis. Many are misdiagnosed, sometimes for years, with chronic yeast infections and others give up, marginalized by dismissive phrases such as, “You just need more lube”, or worse, “It’s all in your head”.
While the precise cause of vulvodynia is unknown most experts agree the pain is caused by a miscommunication in the nervous system. Some women also have muscle spasm in the pelvic floor (the muscles that control the bladder and bowels), which puts pressure on the nerves causing more pain.
The nerves in the genital area are very sensitive and chemicals in everyday life, such as soaps, dryer sheets, and personal lubricants, can make things worse. Wear cotton underwear and for temporary relief consider ice packs (a bag of frozen peas works quite well) or soothing topical therapies such as cool tea bags or zinc oxide ointment. Other factors to consider are stress and depression, which can change brain chemistry affecting nerve pain– this is not the cause of your pain, but it can make things worse, just like putting fuel on a fire.
Common therapies include prescription medications, either topical or by mouth, to target the abnormal nerve signaling and specialized physical therapy for the muscles of the pelvic floor. Some women can also benefit from injections that target the nervous system or the muscles. Other options include biofeedback, acupuncture, and meditation.