Vulvodynia: Causes and Complications

November 29, 2019
Pain in the genital area is the main symptom of vulvodynia. It may be constant or sporadic and may only appear when you touch the sensitive area.

Vulvodynia is discomfort or chronic pain in the vulva. That is the area surrounding the opening of the vagina. Vulvodynia doesn’t have a specific known cause.

The pain, burning, and irritation associated with vulvodynia can lead to all kinds of discomforts. For instance, sitting for long periods of time or having sex becomes unthinkable. Unfortunately, this condition can last from months to years.

If this sounds familiar, don’t let the absence of visible signs and embarrassment keep you from talking about this with your doctor. They should be able to determine the cause and tell you about the available options to reduce your discomfort.

Symptoms

A woman holding her pee.

Pain in the genital area is the main symptom of vulvodynia. In addition, other symptoms may appear such as:

  • Burning
  • Inflammation
  • Stinging
  • Painful sexual intercourse (dyspareunia)
  • A pulsating sensation
  • Itching

The pain may be constant or sporadic. Also, it may only appear when you touch the sensitive area or feel generalized pain throughout the vulvar area. Likewise, you may also feel pain in the opening of your vagina. Furthermore, your vulvar tissue may be slightly inflamed or swollen, although the vulva may seem fine for the most part.

However, make sure not to confuse it with a similar disease: vestibulodynia. This latter only causes pain when you put pressure on the area around the entrance of the vagina.

Read also: Remedies to Treat a Vaginal Yeast Infection

Diagnosis

Before diagnosing you with vulvodynia, your doctor will most likely ask you about your history and may also recommend tests such as:

A pelvic exam

The doctor will visually inspect the outside of your genitals and vagina to see if there are signs of infection or any other signs.

Even if there’s no evidence of infection on sight, the doctor may take a sample of vaginal cells to determine whether there’s an infection such as vaginal candidosis or bacterial vaginosis.

Hyssop Test

Here the doctor uses a moistened swab to check the specific sore areas of the vulvar region.

You may be interested: Vaginal Herpes – What is It and How to Prevent It

Vulvodynia treatment

There are various treatment options. These include:

  • Topical medications in the form of local anesthetics and hormonal creams.
  • Pharmacological treatments such as analgesics, antidepressants, and anticonvulsants.
  • Biofeedback therapy to reduce the sensation of pain.
  • Physiotherapy to strengthen the pelvic floor muscles.
  • Corticosteroid or anesthetic injections.
  • Surgery to remove any affected skin and tissues affected by localized vulvodynia.
  • Dietary changes. For this, some doctors suggest a diet low in oxalates as these form crystals in the body when the kidneys can’t filter them.
  • Complementary or alternative therapies such as relaxation, massages, homeopathic therapies, and acupuncture.
A surgery room.

Vulvodynia surgical treatment

Surgery as treatment is an option for women with severe vulvar pain due to prolonged vulvar vestibulitis you cannot relieve through other means. A vestibulectomy consists of removing painful tissue from the vestibular area. In turn, it helps relieve pain so a woman will be a lot more comfortable during sex.

However, surgery is usually the last resort and isn’t recommended for women with generalized vulvodynia.

Changes in lifestyle

Being nice and gentle with your vulva can help relieve your pain. For instance, you can follow these guidelines:

  • Wear 100% cotton underwear and also avoid tight socks.
  • Don’t douche.
  • Use mild soaps when you shower or bathe and clean the vulva with water only.
  • Don’t use wipes or vaginal deodorants.
  • Use lubricants during sex.
  • Put cold gel bags on your vulva to reduce pain and itching.
  • Stay away from any exercises that directly put pressure on your vulva. This includes riding a bicycle, for example.

Vulvar pain could have an emotional or psychological component, so some women benefit from receiving either psychological support or sexual therapy or both.

Alternative or complementary treatments such as yoga and acupuncture may be useful for managing the pain from vulvodynia. However, there’s little evidence in regard to the effectiveness of these approaches.

Possible complications of vulvodynia

Finally, this condition can naturally also have a physical and emotional impact. It can generate problems of different kinds such as:

  • Problems in personal relationships
  • Depression and anxiety
  • Sleeping disorders
  • Sexual problems

If this is your case, don’t hesitate to see a therapist. Remember: all of these can be treated with the right help. 

  • Ricci A, P. (2010). VULVODINIA: UN DIAGNÓSTICO OLVIDADO FRENTE AL DOLOR VULVAR. Revista Chilena de Obstetricia y Ginecología. https://doi.org/10.4067/S0717-75262010000100011

  • Gallo, J. L. (2011). Vulvodinia, un problema olvidado y difícil de resolver. Clinica e Investigacion En Ginecologia y Obstetricia. https://doi.org/10.1016/j.gine.2011.03.007

  • Itza, F., Zarza, D., Gómez-Sancha, F., Salinas, J., & Bautrant, E. (2012). Puesta al día en el diagnóstico y tratamiento de la vulvodinia. Actas Urologicas Espanolas. https://doi.org/10.1016/j.acuro.2011.11.004