What is Vulvodynia?
The International Society for the Study of Vulvovaginal
Disease (ISSVD) defines vulvodynia as chronic vulvar
discomfort or pain, especially that characterized by
complaints of burning, stinging, irritation or rawness
of the female genitalia. Burning sensations are the
most common, but vulvodynia pain is highly individualized.
The condition varies in persistence and location. Pain
may be constant or intermittent, localized or diffuse.
In many cases of vulvodynia, pain occurs spontaneously.
Vulvar vestibulitis, a type of vulvodynia refers to
pain experienced only when pressure is applied to the
vestibule, the area surrounding the entrance to the
vagina. Vulvodynia has also occasionally been referred
to as pudendal neuralgia.
Vulvodynia, as with most chronic pain conditions, has
a profound impact on quality of life. It often affects
one's ability to engage in sexual activity and can interfere
with daily functioning. It can impair one's ability
to work, engage in physical activity, and participate
in a social life. These limitations can negatively affect
self-image and may sometimes lead to depression.
What Causes Vulvodynia?
The cause of vulvodynia is unknown. It may be the result
of multiple factors. Doctors speculate that it may be
- an injury to, or irritation of, the nerves that
innervate the vulva;
- a localized hypersensitivity to candida;
- an allergic response to environmental irritants;
- high levels of oxalate crystals in the urine; or
- spasms of the muscles that support the pelvic organs.
There is no evidence that vulvodynia is caused by infection
or that it is a sexually transmitted disease.
Diagnosis and Treatment
Vulvodynia is diagnosed
when other causes of vulvar pain, such as active yeast
infection, herpes, skin disorders, and other bacterial
infections are ruled out. Upon examination, the vulvar
tissue may appear inflamed and swollen or it may look
perfectly normal. It is common for a woman to consult
several doctors before obtaining an accurate diagnosis.
Currently there is no cure for vulvodynia. Treatments
directed toward symptom relief include drug therapies
such as tricyclic antidepressants or anticonvulsants,
nerve blocks, interferon, biofeedback, and diet modification.
Surgical intervention is an option for some women when
more conservative treatments do not produce acceptable
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- Evidence for overlap between urological and nonurological
unexplained clinical conditions.
- Measuring treatment outcomes in women with vulvodynia.