What is Vulvodynia

Vulvodynia is defined as chronic vulvar discomfort or pain, emerged by burning, stinging, irritation or rawness of the female genital region in cases in which there is no infection or skin disease of the vulva or vagina causing these symptoms. Burning sensations are the most familiar, but the type and severity of symptoms are highly individualized. Pain may be steady or intermittent, localized or diffuse.

Causes of vulvodynia:
There is no known cause of vulvodynia. Below are the several possibilities:
• Injury to, or irritation of, the nerves that innervate the vulva
• An abnormal response of different cells in the vulva to environmental factors (as infection or trauma)
• Genetic factors associated with susceptibility to chronic vestibular inflammation
• A localized hypersensitivity to yeast
• Spasms of the muscles that support the pelvic organs

Diagnoses of vulvodynia:
Vulvodynia is diagnosed in part by ruling out all other causes of vulvar pain. Doctors will likely take a whole history, do an examination of the vulva, vagina, and vaginal secretions, as well as perform fungal vaginal cultures to rule out contamination. They may do a “q-tip test” where they touch different regions of the vulva and vestibule to decide the location and severity of pain. They may take a biopsy of skin that looks suspicious.

Treatment of vulvodynia:
There is presently no "cure" for Vulvodynia. Treatments are bound for toward alleviation of symptoms and may give partial or complete relief. It is important to keep in mind that the cause of vulvodynia is unknown and each woman’s symptoms are unique; no particular treatment works all the time or is appropriate for every single patient. Some women respond very well to a particular treatment, while others react poorly or experience unacceptable side effects.
Some of the current treatments available include:
• Discontinuation of all topical medications, soaps, douches, etc., that can worsen irritation
• Tricyclic antidepressant medications (e.g., amitriptyline, nortriptyline, desipramine)
• Anticonvulsants (e.g., Tegretol, Neurontin)
• Interferon injections
• Nerve blockades
• Topical estrogen cream
• Pelvic floor therapy (for patients who have pelvic floor muscle abnormalities as measured by surface electromyography)
• Surgery (for vulvar vestibulitis syndrome only)

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