The vulva includes the external region of the female genitalia, including the pubic mound, the labia majora and minora, the clitoris and the perineum. It is commonly referred to as the vagina.
In this article:
Everything You Need to Know about Vulvodynia
What is Vulvodynia?
Vulvodynia is chronic pain or discomfort around the opening of your vagina (vulva) for which there’s no real, known cause and it lasts for at least three months. The pain, burning, and irritation commonly detected with vulvodynia can make you so uncomfortable that sitting for long periods or having sex becomes unthinkable and unbearable. This condition can last from anywhere between months to years.
What are the Symptoms of Vulvodynia?
You may feel a lot of throbbing, itching, aching, a lot of soreness and swelling.
The pain can be within a particular spot or it may be spread over a wider region, including the clitoris, the perineum, the pubic mound, and the inner thighs. It can also affect the area around the urethra, unfortunately.
What are the Causes of Vulvodynia?
Doctors don’t know what causes this condition, but likely contributing factors include:
- Injury to or irritation of the nerves in the vulvar region
- Previous vaginal infections and rashes on the genital area
- Allergies or sensitive skin
- Recurring yeast infections
- sexually transmitted infections (STIs)
- Chemical irritation of the external genitals, caused by soaps, feminine hygiene products or detergents used in clothing
- Any laser treatments or surgery on the external genitals
- Hormonal changes
- Muscle spasms or weakness in the pelvic floor, which supports the uterus, bladder, and bowels
How can I Treat Vulvodynia?
There are no real cures for vulvodynia but doctors can prescribe treatments for the symptoms. Since the cause is unknown, finding a solution that works will take some trial and error.
For many, a combination of treatments works great. It can take time to find the right treatments, and it can take time after starting your treatment before you notice any relief.
Your doctor will offer several treatment choices, including:
- Medications: these include steroids, antidepressants or anticonvulsants that can help lessen the chronic pain while antihistamines might reduce itching.
- Pelvic Floor Therapy: Many women with vulvodynia feel the tension in the muscles of the pelvic floor, which supports the uterus, bladder, and bowel. Exercises to relax those muscles can help relieve your vulvodynia pain.
- Biofeedback Therapy: This therapy can help reduce your pain by teaching you how to relax your pelvic muscles.
- Nerve Blocks: Women who have pain that doesn’t respond to other treatments might benefit from local nerve block injections.
- Local Anesthetics: Medications, such as lidocaine ointment, can provide temporary symptom relief. Your doctor might recommend applying lidocaine half an hour before sexual intercourse to reduce pain and using lidocaine ointment can cause your partner to have temporary numbness after sexual contact.
- Surgery: In severe cases of localized vulvodynia, surgery can be done to remove the affected skin and tissue (called vestibulectomy) to relieve pain.
What Home Remedies can I Try?
The following tips could help you manage vulvodynia symptoms:
- Try applying cold compresses or gel packs, place them directly on your external genital area to ease pain and itching.
- Try soaking in a sitz bath two to three times a day. Sit in comfortable, lukewarm or cool water with Epsom salts for five to 10 minutes.
- Avoid tightfitting clothing and nylon underwear, since tight clothing restricts airflow to your genital area, often leading to increased temperature and moisture that cause irritation. Wear light cotton underwear to increase ventilation and dryness and try sleeping without underwear at night.
- Avoid hot tubs, hot pools and soaking in hot baths. Spending time in hot water can increase discomfort and itching.
- Do not use scented deodorants, tampons or pads on your vulva, since they can increase irritation. If your pads are irritating, switch to 100% cotton pads. Also, avoid douching.
- Avoid activities that put pressure on your vulvae, such as biking, cycling or horseback riding.
- Wash gently and avoid scrubbing the affected area harshly or washing too often, since this can increase irritation. Instead, use lukewarm water to gently clean your vulva with your hand and pat the area dry. After bathing, apply plain petroleum jelly cream to create a protective barrier.
- Use lubricants while having sex. If you’re sexually active, apply lubricant generously before having sex. Avoid using products that contain alcohol, flavor, and warming or cooling agents.
When should I go see a Doctor?
If the pain becomes unbearable, you should visit a gynecologist. You should be ready to describe the pain, including the type of pain and its severity, mention when it started, and whether it began gradually or suddenly, where it hurts and how often. Mention any and all previous medical history that could be the cause of this, such as diabetes, herpes, etc.
Once your doctor has assessed your symptoms and taken a biopsy, they can recommend treatments and ways to help you manage your discomfort.