Vulvodynia : What it is, Symptoms, Prevention And Treatment ?

Vulvodynia is a persistent pain or discomfort that develops around the entrance of your vagina (vulva), lasts for at least three months, and has no known cause. Long durations of sitting or having sex may become impossible due to the discomfort, burning, or irritation that accompanies vulvodynia. The condition might linger for months or even years.

Do not let the lack of outward symptoms or shame about disclosing the problems prevent you from getting care if you have vulvodynia. There are treatments that might help to ease your discomfort. It is crucial to undergo an examination since your doctor might be able to identify the reason for your vulvar pain.

Causes

Although there is no known cause of vulvodynia, the following variables may contribute:

• Your vulvar region's nerves may have been hurt or irritated.
• Past infections of the vagina
• Sensitivity to allergens or skin
• Hormone adjustments
• Weak or tense pelvic floor muscles, which support the uterus, bladder, and intestines,

How to check if you have Vulvodynia?

Vulvodynia is a rather prevalent illness, despite the fact that many women fail to disclose it to their doctors.

Discuss your genital pain with your doctor or get a referral to a gynaecologist if you have any discomfort. The more readily curable causes of vulvar discomforts, such as yeast or bacterial infections, herpes, precancerous skin diseases, genitourinary syndrome of menopause, and medical illnesses including diabetes, should be ruled out by your doctor.

It is also crucial to avoid regularly using over-the-counter medications for yeast infections without first consulting a physician. Your doctor might suggest therapies or techniques that will help you manage your pain after assessing your symptoms.

Symptoms

The primary vulvodynia symptom is vaginal discomfort, which is best described as:

• Burning
• Soreness
• Stinging
• Rawness
• Painful sex exchange (dyspareunia)
• Throbbing
• Itching

You could have occasional or ongoing discomfort. It could only happen if you touch the sensitive region (provoked). The discomfort may be widespread across your whole vulvar area or may only be felt in a specific location, such as the entrance of your vagina (vestibule).

Vulvar tissue may seem slightly enlarged or irritated. Your vulva usually seems normal.

Vestibulodynia, a related ailment, only hurts when pressure is put on the region around the vaginal opening.
Treatments

Treatments for vulvodynia concentrate on symptom relief. One course of therapy is not always effective. Many people respond best to a mix of therapies. Finding the best remedies can take time, and it may be some time before you start seeing results from therapy.

Options for treatment include:

Medications. Anticonvulsants, tricyclic antidepressants, and steroids can all help reduce chronic pain. Itching may be lessened with antihistamines.

Biofeedback treatment. By teaching you how to relax your pelvic muscles and manage how your body reacts to the symptoms, this therapy can help you feel less discomfort.

Regional anaesthetics. Medications, including lidocaine ointment, can reduce symptoms momentarily. To ease your discomfort, your doctor may advise administering lidocaine 30 minutes before sexual activity. The use of lidocaine ointment may temporarily numb your partner.

Blocked nerves. Local nerve block injections may help women with chronic pain that does not improve with conventional therapies.

Pelvic floor rehabilitation. Many vulvodynia patients have tightness in the pelvic floor muscles, which support the uterus, bladder, and intestine. Performing relaxation exercises helps ease vulvodynia discomfort.

Surgery. Some women get pain relief following surgery to remove the afflicted skin and tissue (vestibulectomy) in situations of localised vulvodynia or vestibulodynia.

You may find the following advice helpful in managing vulvodynia symptoms:

• Try using gel packs or cold compresses. Apply them right away to your external genital area to ease pain and inflammation.
• Take a bath to relax. Sit comfortably in lukewarm (not hot) or cold water containing Epsom salts or colloidal oatmeal for five to ten minutes two to three times each day.
• Avoid wearing nylon undergarments and tight-fitting pantyhose. Tight clothing prevents air from reaching your genital area, which frequently results in higher temperatures and dampness that might irritate you. To enhance ventilation and dryness, put on white, cotton underclothes. Try going to bed at night without any underpants.
• Avoid bathing in hot pools and baths. Hot water exposure might make you feel uncomfortable and itchy.
• Avoid using deodorant pads or tampons. The body spray can be annoying. If sanitary napkins irritate you, try 100% cotton ones.
• Avoid activities like riding a horse or bicycling that exert pressure on your vulva.
• Gently wash. Excessive cleaning or rough scrubbing of the irritated region might aggravate the condition. Instead, gently wash your vulva with plain water with your palm, then pat the region dry. Apply a preservative-free emollient after bathing to form a barrier, such as basic petroleum jelly.
• Employ lubricants. If you are sexually active, lubricate your partner before bed. Useless items with alcohol, flavours, or warming or cooling agents should not be used.

Prescription drugs from a doctor.

Typically, paracetamol and other common painkillers will not help with vulvodynia discomfort.

However, a number of prescription drugs, such as:

• Drowsiness, weight gain, and dry mouth are all potential adverse effects of the antidepressants amitriptyline and nortriptyline.
• Pregabalin and gabapentin, two anti-epilepsy medications, may cause weight gain, tiredness, and dizziness as adverse effects.
• In order to reduce your pain, your doctor will likely start you on a low dose and then gradually increase it.

The medication may need to be taken for a number of months.

Injections of local anaesthetic and steroids into a neighbouring nerve may temporarily relieve pain if you have it in a particular location of your vulva.

Physiotherapy

You can learn certain pelvic floor exercises from a physiotherapist, such as contracting and relaxing your pelvic floor.

Utilizing vaginal trainers is another method for de-sensitizing and relaxing the vaginal muscles.

These are smooth cones that may be placed into your vagina in the privacy of your own house, and their size and length steadily increase.

TENS (transcutaneous electrical nerve stimulation) may also be recommended by certain physiotherapists as a way to lessen your discomfort.

Here, a device is utilised to apply a gentle electrical current to the afflicted location.

Therapy

By altering your thoughts and behaviours, cognitive behavioural therapy (CBT) seeks to help you manage your difficulties. It frequently enables women to manage the effects of vulvodynia on their lives.

CBT focuses on the issues and challenges you face while seeking out doable solutions to daily mental health issues. When pain interferes with intimacy with your spouse, psychosexual counselling might be useful.

This form of therapy tries to treat issues like sex-related anxiety and dread while re-establishing a physical connection with your spouse.

Surgery 

Only very seldom is surgery performed to remove a portion of the vulva. However, the discomfort may return, and it is often not advised.

Complications of Vulvodynia

Vulvodynia can lead to emotional issues since it can be uncomfortable and irritating, and it might prevent you from wanting sex. For instance, the muscles around your vagina might spasm due to the dread of having intercourse (vaginismus). There may be further issues, such as:

• Anxiety
• Depression
• Disruptions in sleep
• Sexually inappropriate
• Different body image
• Relationship difficulties
• The lower level of quality of life

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