What is Vulvodynia?

painful - vulvodyniaWomen describe feeling intense burning, rawness, sharp stabbing pains, and soreness involving any part of the vulva (the genital area between the legs and outside of the vagina). For some the pain can feel like “having a cut and having chilli rubbed into it”. The discomfort may interfere with their ability to sit, wear tight clothing, walk, ride a bike and be sexually active. In fact, sexual intercourse can cause agonizing pain. One of the harshest and most upsetting symptoms of vulvodynia is dyspareunia, an often unthinkable pain during intercourse.

A study carried out in the US, suggests that about one in six women have experienced the symptoms for more than three months during their lives. And fewer than half will seek treatment, so they suffer in silence. Women with vulvodynia vary in ages from 16 to 80 years with the majority between the ages of 20 to 50 years. Studies indicate that early pain syndromes may affect future development of body image, self-esteem, and attitudes toward sexual behavior and functioning.

A part of the problem in diagnosing vulvodynia is that there are few symptoms to be seen during a physical examination; sometimes none. After seeing many different doctors in a desperate attempt to find out what is wrong, some women may be left thinking it is all in their heads? Undiagnosed pain in the vulva area has often been regarded by doctors as a psycho-sexual issue and they are sent to see sexual therapists. Many see gynaecologists who place them on Esteroil or other topical ointments in hope that this will help relieve the symptoms. For the majority of women, they will not.

Common Symptoms

Women

Low back pain
Heavy feeling in the pelvic
Radiating leg pain
Pain with urination and/or bowel movements
Bowel complaints such as constipation or diarrhea
Suprapubic (over your bladder) pain
Coccyx pain
Stomach pain or bloating
Irregular menstrual cycle
Pain with menses
Painful sex causing decreased sexual activity

Men

Pain in the scrotal, perineal, inguinal and bladder areas
Pain with ejaculation and/or bowel movements

Vulvodynia is not rare! A study published in 2013 in the American Journal of Obstetrics & Gynecology found that more than 8 percent of women suffer from it and concluded that the condition “is common, although rarely diagnosed.” (By way of comparison, the same percentage of men and women combined suffer from asthma)

The University of Michigan conducted a recent study that included 2,269 women in the metro Detroit area. They found that more than 25 percent of these women had experienced ongoing vulvar pain at some point in their lives. However, only two percent of women had sought treatment for their pain. 

The Exam

A Q-tip test is usually performed by a doctor, which identifies parts of localized pain in the vulva. The patient lies down on an examination table, legs splayed by stirrups, her vagina held open with a speculum. The doctor uses the cotton Q-tip to lightly touch various parts of the inner thigh and the labia; then they circle clockwise into the vestibule and move inward to the clitoris and vaginal opening. Many women who endure this procedure don’t feel like they are being lightly touched; they report feeling insufferable pain, as if they are being stabbed with a knife. 

Remember that just because there is no sign of pain or trauma in the vulva/vagina, this does not mean that the pain is “in your head.” Find a provider who understands vulvodynia and supports you.

Especially consider seeing a pelvic floor physiotherapist. Vulvodynia is associated with chronic tightness and lack of control or awareness of the pelvic floor muscles. Hands-on training with a pelvic floor physiotherapist can be an integral part of treatment.

Dr. Natalie Rosen is a current researcher on Vulvodynia and has a lot of material on managing pain as well. 

Acupuncture Deemed Feasible for Vulvodynia – Acupuncture seems feasible for treatment of women with vulvodynia, according to a study published online Jan. 30 in The Journal of Sexual Medicine.

Dr. Glazers’s Vulvodynia.com website –  support and exchange of information for patients, their support networks, treating professionals, and researchers.

Some women find that dilators help with their Vulvodynia. Here is a great guide by Tracy Sher, MPT to help you out.