Vulvodynia Definition

Vulvodynia Definition
Medically Reviewed by Trina Pagano, MD on September 09, 2020
Vulvodynia i s a chronic pain condition of the vulva (outer female genitals). It usually lasts more than 3 months and there’s no known cause. Even though it’s the leading cause of painful sex among women who haven’t gone through menopause, it’s hard to know how widespread vulvodynia is. Many women find it hard to discuss the problem with their doctor. And once they do, it’s easy for doctors to diagnose vulvodynia as something else. Researchers are working hard to uncover the causes and to find better ways to treat it.
Vulvodynia affects the vulva, your external female genital organs. This includes the labia, clitoris, and vaginal opening. There are two main types:
Generalized vulvodynia is pain in different areas of the vulva at different times. Vulvar pain may be constant or happen every once in a while. Touch or pressure may or may not cause iit. But it may make the pain worse.
Localized vulvodynia is pain in one area of the vulva. Often a burning sensation, this type of vulvar pain usually results from touch or pressure, like sex or prolonged sitting.
Doctors don’t know the cause of most forms of vulvodynia. And there’s no proof that infections, such as sexually transmitted diseases (STDs), lead to vulvodynia.
Researchers are trying to find the causes. They may include:
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
Allergies or irritation to chemicals or other substances
Women who have vulvodynia may also have another type of pain syndrome. This means there may be a link between vulvodynia and pain conditions like:
An estimated 200,000 to 6 million women
Multiple ethnicities. It was once thought to mainly affect white females, but it’s also found in African American and Hispanic women
Possible risk factors for vulvodynia include:
Post-traumatic stress disorder (PTSD)
Symptoms of vulvodynia usually begin suddenly and can last anywhere from months to years.
The most common symptoms of vulvodynia include:
You may feel symptoms of vulvodynia:
All the time or just once in a while
During activities such as exercise , sex, or walking
While bicycling, inserting tampons, or even sitting
In one specific area or throughout your entire vulva
A burning pain is the single most common vulvodynia symptom. Some women describe it as a knife-like pain or like someone poured acid on their skin .
Most of the time your vulva will look normal, but it might appear inflamed or swollen.
To diagnose vulvodynia, your doctor may:
Ask about your medical, sexual and surgical history. This helps them understand exactly where and how much pain (and other symptoms) you’re having.
Give you a pelvic exam. They’ll check your external genitals and vagina for things that might be causing your symptoms. They might take a sample of cells from your vagina to test for an infection.
Do a cotton swab test. For this test the doctor uses a cotton swab to check for exact areas of pain in your vulvar region.
Do a biopsy. The doctor will take a small piece of tissue from a particular area to examine it further. They’ll only do this if they find a sore or something else unusual.
Vulvodynia symptoms aren’t life-threatening, but they can still have a huge impact on your life. Vulvar pain can take a toll on your normal activities. It can make it hard to have sex , exercise , socialize, or work. Severe symptoms or trouble having sex can also affect your relationship. This, in turn, could harm your self-image and make you feel depressed. A National Institutes of Health study showed that most women with vulvodynia feel ''out of control,'' unable to have sex and unable to fully enjoy life. If this is true for you, don’t hesitate to seek the help and support you need.
Many women find ways to control their pain. Unfortunately, many doctors aren’t familiar with vulvodynia. If you have this condition, look for a doctor who has experience treating it. Also, remember that chronic pain can affect your emotions. Think about getting therapy or joining a support group.
It may help to stay away from things that could irritate your vulva. These might include certain soaps, medications , or douches. You can:
Use a dermatologist-approved detergent
Don’t use fabric softener on your panties.
Use unscented toilet paper that’s soft and white.
Use 100% white cotton menstrual pads, and tampons.
Don’t get shampoo on the vulvar area.
Avoid perfumed creams or soaps, pads or tampons, and contraceptive creams or spermicides.
Stay out of hot tubs or pools with lots of chlorine.
Rinse your vulva with cool water after you pee or have sex.
Avoid foods that make your urine more irritating. This may include greens, beans, berries, chocolate, and nuts.
Wear loose-fitting pants and skirts
Remove wet swimsuits or damp gym clothes as soon as you can.
After bathing, gently pat your vulva dry and apply a vegetable or plant-based oil or preservative-free emollient to protect it.
Some activities put pressure on your vulva. To ease it you can:
Use a water-soluble lubricant during sex.
Avoid activities that put direct pressure on your vulva. This includes bicycling and horseback riding.
These steps may help relieve vulvar pain:
Soak in lukewarm or cool sitz baths.
After sex, apply ice or a frozen gel pack wrapped inside a hand towel to the area.
There’s no one treatment for vulvodynia that works for all women. You may need to try a combination of things for the best results. Your doctor may suggest.
You might get a pill, a cream or ointment you rub onto the skin, or a shot. Your doctor may suggest:
Local anesthetics, such as lidocaine
Serotonin-norepinephrine reuptake inhibitors
Neurostimulation and spinal infusion pump
The doctor may also suggest treatments like:
Physical therapy , which involves exercise to strengthen pelvic muscles and ease muscle spasms
Biofeedback , which helps you learn to relax vaginal muscles to lessen pain
Transcutaneous electrical nerve stimulation (TENS). This treatment uses a low volt electrical current to ease pain.
If you have a type of localized vulvodynia called provoked vestibulodynia, your doctor may suggest surgery to remove painful tissue, especially if other options haven’t helped.
If your doctor doesn’t have experience with surgery for provoked vestibulodynia, consider seeing a gynecologist with a special interest in this condition. Ask your doctor for a referral.
SOURCES:
National Vulvodynia Association: ''Fact Sheet;'' ''What Is Vulvodynia?;'' ''What Causes Vulvodynia?;'' ''Self-Help Tips for Vulvar Skin Care;'' and ''Treatment.''
The American College of Obstetricians and Gynecologists: ''Vulvodynia;' ACOG Committee Opinion No 673: “Persistent Vulvar Pain.
"American Academy of Family Physicians: ''What Is Vulvodynia?''
Office of Research on Women’s Health: ''Vulvodynia.''
UpToDate: "Clinical manifestations and diagnosis of vulvodynia (vulvar pain of unknown cause),” “Treatment of vulvodynia."
Cleveland Clinic: “Transcutaneous Electrical Nerve Stimulation (TENS),” “Vulvodynia.”
Fort Memorial Hospital, Fort Health Care: “Vulvodynia & Vaginismus.”
© 2005 - 2022 WebMD LLC. All rights reserved.
WebMD does not provide medical advice, diagnosis or treatment.

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vul·vo·dyn·ia

| \ ˌvəl-vō-ˈdin-ē-ə

\

: chronic discomfort of the vulva of uncertain cause that is experienced as burning or shooting pain, stinging, or irritation

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“Vulvodynia.” Merriam-Webster.com Medical Dictionary , Merriam-Webster, https://www.merriam-webster.com/medical/vulvodynia. Accessed 11 Jul. 2022.
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Vulvodynia, simply put, is chronic vulvar pain without an identifiable cause. The location, constancy and severity of the pain vary among sufferers. Some women experience pain in only one area of the vulva, while others experience pain in multiple areas. The most commonly reported symptom is burning, but women’s descriptions of the pain vary. One woman reported her pain felt like “acid being poured on my skin,” while another described it as “constant knife-like pain.”
There are two main subtypes localized and generalized vulvodynia, which sometimes co-exist.
Most women have pain at only one vulvar site. If the pain is in the vestibule, the tissue surrounding the vaginal opening, the diagnosis is vestibulodynia (formerly known as vulvar vestibulitis syndrome (VVS)). (See diagram on right.)
The majority of women with localized vulvodynia have Provoked Vestibulodynia (PVD), in which pain occurs during or after pressure is applied to the vestibule, e.g., with:
A less common form of localized vulvodynia, known as clitorodynia (pain in the clitoris), can be very painful.
PVD is further classified as primary or secondary .
Women with primary PVD have experienced vestibular pain since the first attempt at vaginal penetration.
Women with secondary PVD have experienced pain-free sexual intercourse prior to the development of vulvar pain.
For women with generalized vulvodynia (GV), pain occurs spontaneously and is relatively constant, but there can be some periods of symptom relief.
Activities that apply pressure to the vulva, such as prolonged sitting or sexual intercourse, typically exacerbate symptoms.

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The National Vulvodynia Association is a nonprofit organization that
strives to improve women's lives through education, support, advocacy
and research funding. The NVA is not a medical authority and strongly
recommends that you consult your own health care provider regarding any
course of treatment or medication.

Medically Reviewed by Traci C. Johnson, MD on January 14, 2021
Constant and knife-like. Burning. Stinging. Soreness. Stabbing. This is how women with vulvodynia describe the pain they feel around the opening of their vagina .
There are two types of vulvodynia. Generalized vulvodynia means you feel pain all around your vagina . If you have localized vulvodynia, you feel pain in one specific area. The pain can be consistent or occur only when you sit for a long time or have sex.
It can be hard to discuss with anyone, including your doctor. But talking about what hurts is the first step to help and healing.
Vulvodynia is a pain disorder. Doctors don’t know why it happens. It's not brought on by a sexually transmitted disease ( STD ). Infection, skin disease, or cancer can cause pain around the opening of your vagina, but none of them are the same as vulvodynia.
Vulvodynia affects women of all ages, races, and ethnic backgrounds.
Other factors include hormonal changes, a history of sexual abuse, and sensitive skin issues, like allergies .
Vulvodynia can be so painful you lose the desire to have sex. This can cause relationship issues. It may trigger a condition doctors call “ vaginismus .” That’s where the muscles around your vagina tense up because you’re afraid any kind of penetration will cause pain. Many things, like sex, using a tampon, or having a pelvic exam , might cause this reaction.
It can also affect your body image and sleep patterns, which can lead to anxiety and depression .
National Vulvodynia Association: "What is Vulvodynia?" "What Causes Vulvodynia?"
The American Congress of Obstetricians and Gynecologists: "Vulvodynia."
© 2005 - 2022 WebMD LLC. All rights reserved.
WebMD does not provide medical advice, diagnosis or treatment.

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