Jennifer Wider, M.D.
Society for Women's Health Research
Newswise — Sex is supposed to be enjoyable, but for countless women suffering from vulvodynia, that's not the case. Characterized by pain or discomfort with sexual intercourse, rawness, stinging, itching and burning in the vagina or vulva, vulvodynia is a common condition, but it is often undiagnosed or misdiagnosed.
"The symptoms of vulvodynia mimic those of other, common vulvovaginal infections," explains Christin Veasley, associate executive director of the National Vulvodynia Association in Silver Spring, Md. "Women are routinely and incorrectly told that they have a yeast or bacterial infection over and over again."
Vulvodynia is more prevalent than most health practitioners realize. Roughly 16 percent of women between the ages of 18-64 have experienced chronic vulvar pain for at least three months or more, according to a survey by Brigham and Women's Hospital in Boston, Mass.
The word "vulvodynia," literally means "painful vulva," which is the part of female genitalia that consists of the mons pubis (fatty tissue at the base of the abdomen), the labia, the clitoris and the vaginal opening. Women who suffer from vulvodynia may experience intermittent or constant pain which can persist for months to years.
Making matters worse, vulvodynia is difficult to diagnose. A diagnosis often occurs only after other conditions are excluded. "Vulvodynia is diagnosed when other causes of vulvar pain, such as yeast or bacterial infections, or skin diseases, are ruled out," Veasley said. The tissue of the vulva region may appear swollen or inflamed, but more often than not, it looks normal.
The cause of vulvodynia is unknown. This is partly because there has been a lack of research on the disorder in recent years. What is known is that vulvodynia is not caused by a sexually transmitted disease. According to the National Vulvodynia Association, potential causes include:
- An injury to, or irritation of, the nerves that innervate the vulva.
- An abnormal response of different cells in the vulva to environmental factors (such as infection or trauma).
- Genetic factors associated with susceptibility to chronic vulvar vestibular inflammation.
- A localized hypersensitivity to yeast.
- Spasms of the muscles that support the pelvic organs.
Currently, there is no cure for vulvodynia, but it is important for women to seek medical attention because the pain can be managed and treated. "Treatment is directed at symptom relief and includes drug therapy to 'block' pain signals," Veasley said. "In women who have associated pelvic floor muscle spasm or weakness, physical therapy, biofeedback and/or Botox injections may be incorporated into the treatment plan." Because each case is different, treatment tends to be tailored based on individual needs and responses.
Some women find self-care measures to be helpful in alleviating the symptoms of vulvodynia. These include: cold compresses, anti-histamines, the use of lubricants before sexual intercourse and avoiding triggers like hot tubs, tight-fitting undergarments and irritating soaps and detergents. It is highly recommended to work together with a health care provider who can help identify the approach that works best for each individual.
To increase awareness and understanding of this condition, the Office of Research on Women's Health (ORWH) at the National Institutes of Health, in partnership with other federal and non-federal partners including the Society for Women's Health Research, launched a national "Vulvodynia Awareness Campaign" in October. Campaign materials are available on the ORWH Web site at: http://orwh.od.nih.gov/health/vulvodynia.html.
For print copies of the Vulvodynia Awareness Campaign information packet, contact the National Institute of Child Health and Human Development Information Resource Center at 1-800-370-2943 or visit: http://www.nichd.nih.gov/publications.
The National Women's Health Resource Center also has a number of consumer-oriented materials on vulvodynia available online at http://www.healthywomen.org/.
Harlow et al. A Population-Based Assessment of Chronic Unexplained Vulvar Pain, JAMWA. 2003;58:82-88
NIH Office of Research on Women's Health. "NIH Launches Campaign to Raise Awareness of Vulvodynia, a Painful Disorder Affecting Many Women" (Oct. 24, 2007). http://www.nih.gov/news/pr/oct2007/od-24.htm.