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Definition

Vulvodynia is chronic pain or discomfort in the vulva, which are external female genitalia. The vulva includes the labia, clitoris, and vaginal opening.

Female Genitalia

Causes

The causes of vulvodynia are not well known.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors are thought to increase the risk of vulvodynia:

Recurrent yeast infections
Frequent use of antibiotics
Irritation to the genitals by soaps or detergents
Genital rashes
Previous treatment or surgery to the external genitals
History of genital warts
Pelvic nerve irritation or muscle spasms
History of sexual abuse
History of domestic violence

Symptoms

Symptoms of vulvodynia may include:

Pain of the vulva, which may come and go
Burning of the vulva
Stinging of the vulva
Irritation of the vulva
Rawness of the vulva

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:

Pelvic exam
Tests to check for bacteria and/or yeast
Magnified exam, using a colposcope—visual examination of the vulva and vagina using a lighted magnifying instrument
Biopsy —removal of a sample of tissue for testing

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Medications

Topical anesthetics (eg, lidocaine, xylocaine), estrogen creams, and corticosteroid creams can be used to help manage pain. Sometimes injections of steroid into the skin (combined with local anesthetic) may be used. In addition, there is some evidence that tricyclic antidepressant medications (eg, amitriptyline, nortriptyline, and desipramine) can relieve pain and irritation. Other medications such as Neurontin, Cymbalta, and Lyrica are sometimes tried.

Physical Therapy

Physical therapy to help you strengthen and relax your pelvic muscles can ease muscle spasms. This requires a physiotherapist with special training and interest in pelvic floor physiotherapy.

Other Treatments

Interferon injections, laser treatments, and surgery have also been suggested for the treatment of vulvodynia.

Prevention

There is no known way to prevent vulvodynia, since the causes are not well-understood.

RESOURCES:

American College of Obstetricians and Gynecologists

http://www.acog.org

National Vulvodynia Association

http://www.nva.org

National Women's Health Information Center

http://www.4woman.gov

New York Center for Vulvovaginal Pain

http://www.vulvodynia.com

CANADIAN RESOURCES:

Canadian Women's Health Network

http://www.cwhn.ca/indexeng.html

Society of Obstetricians and Gynaecologists of Canada

http://www.sogc.org

References:

About vulvodynia. National Vulvodynia Association website. Available at: http://www.nva.org/about_vulvodynia/what_is_vulvodynia.html. Accessed April 20, 2007.

Vulvodynia. American Academy of Family Physicians website. Available at: http://familydoctor.org/367.xml. Accessed April 20, 2007.

Vulvodynia. National Institute of Child Health & Human Development website. Available at: http://www.nichd.nih.gov/health/topics/Vulvodynia.cfm. Accessed April 20, 2007.

Last reviewed May 2007 by Jeff Andrews, MD, FRCSC, FACOG

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Vulvodynia