Vulvodynia, chronic vulvar pain

Overview  

Vulvodynia is a condition characterized by chronic pain or discomfort around the opening of the vagina (vulva) that lasts for at least three months, and there is no identifiable cause for the pain. The symptoms may include a burning or irritating sensation, making activities like sitting for long periods or having sex unbearable. The condition can persist for months to years. 

There are two main types of vulvodynia, based on the location of the pain: 

• Localized vulvodynia: In this type, the pain is specifically localized to a particular area, such as the vulvar vestibule (the skin between the inner labia and the openings of the urethra and vagina) or the clitoris (the small, bead–like organ at the top of the vulva). It is sometimes referred to as localized vulvar pain syndrome. 
• Generalized vulvodynia: Unlike the localized type, the pain in generalized vulvodynia is more widespread, and it may be experienced in different parts of the vulva and vagina at various times. 

If you are experiencing vulvodynia, don’t allow the lack of visible signs or any embarrassment to prevent you from seeking help, as there are treatment options to alleviate discomfort. Consulting your doctor is essential, as they might be able to identify the cause of your vulvar pain through an examination. 

Vulvodynia treatments primarily aim to alleviate symptoms, but no single treatment is universally effective for every case. Often, a combination of treatments proves to be the most successful approach. Finding the right treatments may require some time and patience, as it may take a while after starting a treatment to experience noticeable relief. 

Symptoms  

Pain in the vaginal area is the most common symptom of vulvodynia. When the pain begins, stops, or becomes the most intense varies for every person. The pain could be constant or intermittent. The pain may be felt across the vulvar area, or it may be confined to a particular area.  

 

The pain in the vulva might be mild to severe. It could feel like:   

• Burning  
• Soreness  
• Stinging  
• Rawness  
• Throbbing  
• Itching  
• Dyspareunia, or excruciating sexual intercourse.  

Vulvodynia is a condition characterized by constant or occasional pain in the vulvar area, which can be provoked by touch. The pain may be generalized throughout the entire vulva or localized to a specific area, such as the vaginal opening. Sometimes, the vulvar tissue might appear slightly inflamed or swollen, but often it looks normal. Another similar condition called vestibulodynia causes pain only when pressure is applied to the area surrounding the entrance of the vagina. Although vulvodynia is relatively common, many women tend not to discuss it with their healthcare providers.  

If you experience genital pain, it’s essential to discuss it with your doctor or seek a referral to a gynecologist. Your doctor should evaluate your symptoms to rule out other easily treatable causes of vulvar pain, such as yeast or bacterial infections, herpes, precancerous skin conditions, genitourinary syndrome of menopause, or medical problems like diabetes. Avoid using over–the–counter treatments for yeast infections without proper medical assessment. Once your doctor has examined your symptoms, they can suggest appropriate treatments or strategies to manage the pain effectively. 

 Causes

Vulvodynia has no known cause. However, there are several potential causes, such as: 

• History of vaginal infections 
• Allergies or skin sensitivity 
• Hormonal imbalance or changes  
• Damage or inflammation of the nerves around the vulvar area 
• Spasms or weakening in the pelvic floor muscles that support the uterus, bladder, and intestines 
• Genetic factors 
• Irritation caused by harsh products that come into contact with the skin  

People with vulvodynia are frequently diagnosed with other common pain conditions, such as fibromyalgia, bladder pain syndrome, irritable bowel syndrome, temporomandibular disorder (TMD). 

Risk factors  

Vulvodynia can occur at any age. However, majority of the diagnosis are among women between the ages of 20 and 60.