Vulvodynia is pain in the vulva that can't be explained by another health problem, such as an infection or a skin problem. The vulva is the genital area outside the body that surrounds the opening of the vagina and the urethra. It also includes the clitoris and the labia.
Doctors don't know the exact cause of vulvodynia. But some things that may help cause it include:
In most cases, vulvar pain is a symptom of some other problem. And when that problem is treated, the pain often goes away. Some conditions that may cause vulvar pain include yeast infections and other vaginal infections, atrophic vaginitis, lichen sclerosus, lichen planus, or an allergic reaction to soaps or other products, such as vaginal sprays or douches.
Pain is the main symptom of vulvodynia. Depending on the person, the pain may:
Other symptoms may include:
Your doctor will first ask you about your past health, your sexual history, and your symptoms. Then you will get a pelvic exam to rule out other possible causes for your pain, such as an infection or a skin problem.
During the exam, your doctor may use a cotton swab to touch different areas on and around your vulva to see where the pain is and how bad it is. If your doctor sees a problem or any skin changes, you may need more tests. Your urine, blood, or other fluids may be checked for infection. Or you may need a biopsy. This means that your doctor will remove a small piece of tissue from your vulva and send it to a lab to be studied for the cause of your pain. Your doctor may also recommend an exam called a colposcopy to take a closer look at the cells on your vulva.
If a cause for your pain is not found, you may have vulvodynia.
There are many treatments for vulvodynia, but what works for someone else may not help you. Work with your doctor to find what is best for you. Even though there is no cure, treatment can help you feel better.
Treatment may include:
Medicines that are applied to the skin, such as estrogen cream or lidocaine ointment, may help relieve pain. Other medicines that may be used include antidepressants, seizure medicines, and nerve blocks.
Specific exercises can help you learn how to control and relax your pelvic muscles. Tightness or spasms in these muscles can make vulvar pain worse.
In rare cases, surgery is done to remove tissue that is very sensitive.
There are other things you can try to relieve your symptoms:
When you have vulvodynia, you may find it hard to do your daily tasks. It may hurt to walk, exercise, or sit for long periods of time. And it may hurt to have sex. All of these things can affect your life, work, and relationships.
Here are some things that may help.
Cognitive-behavioral therapy allows you to express your emotions and concerns and to learn new ways of coping with vulvar pain. Sex therapy can also help you and your partner find ways to be intimate that don't cause pain.
You can track moods, thoughts, activities, and medicines that affect pain. Having a record of pain can help you and your doctor find the best ways to treat it.
A support group can help you share your concerns and hear how other people cope with the pain and challenges of living with vulvodynia.
Meditation and guided imagery are two examples of how you can reduce stress and relax your mind and muscles.
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