Vulvodynia (Chronic vulval pain)

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Kemas kini Tarikh 12/05/2020 . 4 minit bacaan
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Definition

What is vulvodynia?

Vulvodynia is persistent, unexplained pain in the vulva (the skin surrounding the entrance to the vagina).

Vulvodynia can be a long-term (chronic) problem that’s very distressing to live with, but much can be done to help relieve the pain.

How common is vulvodynia?

It can affect women of all ages, and often occurs in women who are otherwise healthy. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of vulvodynia?

The main symptom of vulvodynia is persistent pain in and around the vulva. The vulva usually looks normal.

The pain may be:

  • A burning, stinging or sore sensation
  • Triggered by touch, such as during sex or when inserting a tampon
  • Constantly in the background and can be worse when sitting
  • Limited to part of the vulva, such as the opening of the vagina
  • More widespread – sometimes it can spread to the buttocks and inner thighs

Some women also have problems such as vaginismus (where the muscles around the vagina tighten involuntarily), interstitial cystitis (a painful bladder condition), painful periods and irritable bowel syndrome (IBS).

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes vulvodynia?

Doctors don’t know the cause of most forms of vulvodynia. And there is no evidence that infections, such as sexually transmitted diseases, cause vulvodynia.

Researchers are trying to find the causes of vulvodynia. They may include:

  • Nerve injury or irritation
  • Abnormal response in vulvar cells to an infection or trauma
  • Genetic factors that make the vulva respond poorly to chronic inflammation
  • Hypersensitivity to yeast infections
  • Muscle spasms
  • Allergies or irritation to chemicals or other substances
  • Hormonal changes
  • History of sexual abuse
  • Frequent antibiotic use

Risk factors

What increases my risk for vulvodynia?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is vulvodynia diagnosed?

Before diagnosing vulvodynia, your doctor will ask you questions about your medical, sexual and surgical history and to understand the location, nature and extent of your symptoms.

Your doctor might also perform a:

  • Pelvic exam. Your doctor visually examines your external genitals and vagina for signs of infection or other causes of your symptoms. Even if there’s no visual evidence of infection, your doctor might take a sample of cells from your vagina to test for an infection, such as a yeast infection or bacterial vaginosis.
  • Cotton swab test. Your doctor uses a moistened cotton swab to gently check for specific, localized areas of pain in your vulvar region.

How is vulvodynia treated?

Vulvodynia treatments focus on relieving symptoms. No one treatment works for every woman. For many, a combination of treatments works best. It can take time to find the right treatments, and it can take time after starting a treatment before you notice relief.

Treatment options include:

  • Steroids, tricyclic antidepressants or anticonvulsants can help lessen chronic pain. Antihistamines might reduce itching.
  • Biofeedback therapy. This therapy can help reduce pain by teaching you how to relax your pelvic muscles and control how your body responds to the symptoms.
  • Local anesthetics. Medications, such as lidocaine ointment, can provide temporary symptom relief. Your doctor might recommend applying lidocaine 30 minutes before sexual intercourse to reduce your discomfort. Using lidocaine ointment can cause your partner to have temporary numbness after sexual contact.
  • Nerve blocks. Women who have long-standing pain that doesn’t respond to other treatments might benefit from local nerve block injections.
  • Pelvic floor therapy. Many women with vulvodynia have tension in the muscles of the pelvic floor, which supports the uterus, bladder and bowel. Exercises to relax those muscles can help relieve vulvodynia pain.
  • In cases of localized vulvodynia or vestibulodynia, surgery to remove the affected skin and tissue (vestibulectomy) relieves pain in some women.

Alternative medicine

Stress tends to worsen vulvodynia and having vulvodynia increases stress. Although there’s little evidence that alternative techniques work, some women get some relief from yoga, meditation, massage and other stress reducers.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage vulvodynia?

The following lifestyles and home remedies might help you cope with vulvodynia:

  • Try cold compresses or gel packs. Place them directly on your external genital area to ease pain and itching.
  • Soak in a sitz bath. Two to three times a day, sit in comfortable, lukewarm (not hot) or cool water with Epsom salts or colloidal oatmeal for five to 10 minutes.
  • Avoid tightfitting pantyhose and nylon underwear. Tight clothing restricts airflow to your genital area, often leading to increased temperature and moisture that can cause irritation. Wear white, cotton underwear to increase ventilation and dryness. Try sleeping without underwear at night.
  • Avoid hot tubs and soaking in hot baths. Spending time in hot water can cause discomfort and itching.
  • Don’t use deodorant tampons or pads. The deodorant can be irritating. If pads are irritating, switch to 100 percent cotton pads.
  • Avoid activities that put pressure on your vulva, such as biking or horseback riding.
  • Wash gently. Scrubbing the affected area harshly or washing too often can increase irritation. Instead, use plain water to gently clean your vulva with your hand and pat the area dry. After bathing, apply a preservative-free emollient, such as plain petroleum jelly, to create a protective barrier.
  • Use lubricants. If you’re sexually active, apply a lubricant before having sex. Don’t use products that contain alcohol, flavor, or warming or cooling agents.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Hello Health Group tidak memberikan nasihat perubatan, diagnosis atau rawatan.

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