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Dr. Jennifer Gunter: Understanding Vulvodynia

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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. Having a chronic pain condition wears on your body and psyche so even if you aren’t depressed a psychologist can help you regain some balance in your life.

If you are among the many women with vulvodynia remember you are not alone. Read all that you can about your condition and find a doctor who has expertise in this area. With the right care many women can make significant improvements.

Add a Comment2 Comments

Hi Dr. Gunter

I have been seen by you. I know I have some symptoms of vulvadynia but I don't feel that it fits all my symptoms. I have air escaping from down there and the feeling I get down there is all over my skin. Unfortunately since I got diagnosed Vulvadynia none of my Dr's will consider anything else. I don't feel vulvadynia talks about all my symptoms just some, could there be something else wrong? How do I get my gynecologist to believe there is more to my problem than vulvadynia?????????

August 28, 2010 - 8:52pm
(reply to Simonessaylona)

Hello, you may have diabetes. I found out two years ago type 1 diabetes was the cause of my severe yeast infections and many of my vulvadynia symptoms yet NONE of the numerous doctors I saw every considered this. I still have vulvodyinia unfortunately but the symptoms are greatly improved now that I'm on insulin. I'm trying to post about this to tell everyone to get tested for diabetes, to get a meter and test themselves and to eat a lo carb diet but I can't figure out how to post a discussion here.

April 4, 2014 - 2:22am
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