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Definition

Vulvodynia is chronic pain or discomfort of the vulva. The vulva includes the:

  • Labia majora and labia minora
  • Clitoris
  • Vaginal opening

Female Genitalia

si55550966_96472_1_vulva.jpeg

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Causes

The cause of vulvodynia is not known. Some possibilities include:

  • Injury or irritation of vulvar nerves
  • Inflammed tissue
  • Abnormal response to infection or trauma
Risk Factors

Vulvodynia is more common in women who are younger. Other factors that increase your chance of developing vulvodynia include:

  • History of vulvodynia
  • Chronic pain or disorders associated with chronic pain
  • Sleep disturbances
  • Some mental health disorders, such as post-traumatic stress disorder
  • 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
  • Pelvic nerve irritation or muscle spasms
Symptoms

Symptoms may include:

  • Pain, which may come and go
  • Burning
  • Stinging
  • Irritation
  • Rawness
Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. It may include a pelvic exam. The affected area may need to be examined closely. This can be done using a colposcope to magnify the area.

Your bodily tissues and fluids may need to be tested. This can be done with:

  • Tests to check for bacteria and/or yeast
  • Biopsy
Treatment

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

Medications
  • Topical medications that are applied to the skin, such as corticosteroids, estrogen, or anesthetics
  • Antidepressants
  • Anticonvulsants
  • Prescription pain relievers
Physical Therapy

Therapy can help you strengthen and relax your pelvic muscles. This will ease muscle spasms. You may be referred to a doctor who specializes in pelvic floor issues.

Other Treatments

Suggested treatments for vulvodynia include:

  • Injections
  • Nerve stimulation or nerve blocks
  • Surgery
Prevention

There are no current guidelines to prevent vulvodynia.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org

National Vulvodynia Association
http://www.nva.org

CANADIAN RESOURCES:

Canadian Women's Health Network
http://www.cwhn.ca

Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org

References:

ACOG Practice Bulletin No. 93: diagnosis and management of vulvar skin disorders. Obstet Gynecol. 2008;111:5):1243-1253.

What is vulvodynia? National Vulvodynia Association website. Available at: http://www.nva.org/whatIsVulvodynia.html. Accessed June 26, 2013.

Vulvodynia. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/vulvodynia.html. Updated August 2010. Accessed June 26, 2013.

Vulvodynia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 25, 2013. Accessed June 26, 2013.

Vulvodynia. National Institute of Child Health & Human Development website. Available at: http://www.nichd.nih.gov/health/topics/vulvodynia/Pages/default.aspx. Updated April 3, 2013. Accessed June 26, 2013.

4/7/2014 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Reed BD, Legocki LJ, et al. Factors associated with vulvodynia incidence. Obstet Gynecol. 2014;123(2.1):225-231.



Last reviewed March 2013 by Andrea Chisholm, MD

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.

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