What is vulvodynia?
Vulvodynia is a term that simply means vulval pain or discomfort.
The International Society for the Study of Vulvo-vaginal Disease (ISSVD) divides vulvodynia into different types, depending on where the pain is, and if it is triggered by certain events but this classification does not give the causes (or diagnoses) of the pain.
Vulval pain can be constant or intermittent. In some cases it is only experienced in association with sexual intercourse.
There are many conditions that cause pain of the vulva and in order to treat your problem, you need a specific diagnosis of which one it was that caused your pain.
What are these conditions?
- Most skin diseases can cause pain, and this includes dermatitis, psoriasis and lichen sclerosus which all commonly involve the vulva.
- Anything that causes blistering or rawness of the vulva. This includes some rare skin diseases such as lichen planus, but also allergic reactions to things that have been applied and to drugs that you might be taking.
- Vaginal and vulval infections such as thrush and genital herpes.
- Bladder infections.
- Bowel problems of any type.
- Back problems, particularly the kind that results in sciatica, can be experienced as pain in the vulva.
- Nerve disease and damage.
- Pelvic floor muscle spasm.
How is it treated
By very careful history taking, examination and tests to rule out infection and skin disease.
How is it treated?
This depends entirely on the diagnosis. There is no one treatment. If you have a skin disease or infection, treatment of the underlying condition will cure the pain. However medications and physical therapies such as chiropractic and physiotherapy are also used. In some cases psychological help is needed.
What if I don’t have a skin disease or infection?
If your vulva looks normal and your tests are normal, then it doesn’t mean you don’t have a genuine problem. Pain can be felt in the vulva as a result of disease or malfunction of the lower back, bladder or bowel, and also because of nerve disease or injury. These problems can also be effectively treated.
What if I just have pain with intercourse and nothing else?
This is usually the result of painful pelvic floor muscle spasm. It can start because of problems elsewhere in the pelvis which cause muscle spasm. For example, chronic constipation can result in muscle spasm just behind the vaginal entrance. It is sometimes it can be triggered by psychological stress as well, especially after unhappy sexual experiences. Muscle spasm during intercourse is a very common pain reflex and can be overcome by treating the cause, and relaxation exercises.