Vulvodynia (Vaginal Pain)
Vulvodynia is persistent pain of the vulva, the area around the opening of the vagina.
In females, the vagina is the passage from the cervix to the vulva. The vulva includes the opening of the vagina, the pubic mound, the inner and outer labia (vaginal lips), and the clitoris.
Vulvodynia is considered to be pain for which there is no known cause. It is different from pain that is located deep in the pelvis or internally in the vagina.
An estimated 9 to 18 percent of women between ages 18 and 64 experience vulvar pain at some point.
What causes vaginal pain (vulvodynia)?
Women with vulvodynia have chronic vulvar pain with no known cause. It is not thought to be related to sexually-transmitted diseases (STDs). Until recently, doctors didn’t recognize this as a real pain syndrome. Even today, many women do not receive a diagnosis. They may also remain isolated by a condition that is not easy to discuss.
Researchers are trying to find the causes of vulvodynia. They may include:
➤Nerve injury or irritation
➤Abnormal response in vulvar cells to an infection or trauma
➤Genetic factors that make the vulva respond poorly to chronic inflammation
➤Hypersensitivity to yeast infections
➤Muscle spasms
➤Allergies or irritation to chemicals or other substances
➤Hormonal changes
➤History of sexual abuse
➤Frequent antibiotic use
What are the types of Vulvodynia (vaginal pain)?
Vulvodynia affects the vulva, the external female genital organs. This includes the labia, clitoris, and vaginal opening.
There are two main subtypes of vulvodynia:
Generalized vulvodynia is pain in different areas of the vulva at different times. Vulvar pain may be constant or occur every once in a while. Touch or pressure may or may not prompt it. But this may make the pain worse.
Localized vulvodynia is pain in one area of the vulva. Often a burning sensation, this type of vulvar pain is usually provoked by touch or pressure, such as intercourse or prolonged sitting.
What are the symptoms of vaginal pain?
Symptoms of vulvodynia usually begin suddenly and can last anywhere from months to years.
The specific symptoms of vaginal pain and discomfort vary, depending on the underlying cause.
Depending on your specific condition, you might experience one or more of the following symptoms associated with vaginal pain:
➽Burning
➽Itching
➽Soreness
➽Stinging
➽Throbbing
➽Rawness
➽Pain during intercourse
If your vaginal pain is caused by an infection, you may develop abnormal vaginal discharge. For example, it may look or smell different than usual. This can indicate a yeast or bacterial infection.
How is vaginal pain diagnosed?
There are no specific tests that confirm vulvodynia, and the diagnosis is made based upon the characteristic symptoms. Your doctor will likely take your medical history, conduct a physical exam, and if needed, ordering one or more tests.
During this examination, he/she will check for signs of redness, swelling, damage, or scarring. They may apply pressure with a cotton-tipped applicator to your vulva and vagina to check for pain. If you have vulvodynia, you might experience severe pain when any pressure is applied.
If your doctor suspects you have a serious condition, such as cervical cancer, they may recommend further testing. This can consist of obtaining tissue samples from the cervix for analysis.
How is vaginal pain treated?
No one treatment works for everyone with vulvodynia. If you're experiencing vulvar pain, talk to your doctor about what treatments might work best for you.
Treatment options include:
Medicines
If you have a bacterial or fungal infection, your doctor will likely prescribe antibiotics or antifungal medications to treat it.
Other medicines may include:
Prescription skin ointments or hormone creams
Medications, including antidepressants, anticonvulsants, and pain relievers
Injections of anesthetic (numbing) medications
Physical therapy (exercises to strengthen the pelvic muscles, or electrical stimulation)
Complementary treatments (such as acupuncture and massage)
Surgery
Surgery may be an option for people with some types of vaginal pain. During the surgery, your doctor will remove tissue from the painful area of the vulva.
Surgery isn't recommended for most people with vulvodynia.
Home care
There are a number of steps you can take at home to help ease vaginal or vulvar pain:
Applying witch hazel pads to your vaginal area may soothe irritation. You can purchase pre-treated witch hazel pads at many drugstores or natural health stories. Alternatively, you can dip your own cotton pads in witch hazel solution.
To relieve pain following urination, it may help to pour clean, lukewarm water over your vulva after going to the washroom. This will help cleanse and soothe the area.
To relieve or prevent pain caused by sex, it may help to use a lubricant during sexual intercourse.
To alleviate vaginal itching, over-the-counter antihistamines may help.
What is the outlook (prognosis) for vaginal pain and vulvodynia?
Outlook depends on the underlying cause of your vaginal pain, as well as the treatment you receive. In many cases, following your doctor’s recommended treatment plan can provide lasting relief.
You should keep in mind that Vulvodynia is a chronic condition, meaning that it may persist for months to years. In other women it may come and go.
