One of the most frustrating and embarrassing things a woman can deal with is unexplained burning, soreness, itching, or pain “down there.” These discomforts not only interfere with daily life and intimacy but also pose a challenge when it comes to identifying the underlying cause, given the numerous medical conditions that may exhibit similar symptoms.
In searching for answers, you’ve probably read a laundry list of possible causes, from yeast infections or bacterial infections to endometriosis, inflammatory disease such as adenomyosis, ovarian cysts, PCOS, sexually transmitted disease (STD), and beyond.
However, there is one condition that often goes overlooked: vulvodynia. Chances are you’ve never even heard of this chronic pain condition that causes discomfort in the female genital area, but it is actually quite common. In fact, vulvodynia is the leading cause of painful intercourse (dyspareunia) and chronic pelvic pain among young women in their reproductive years.
In this blog, we will tell you everything you need to know about this often misdiagnosed pain condition. We’ll explore the different types of vulvodynia, the areas of the vulva it can affect, the symptoms you might experience and how they can differ from conditions that cause similar discomfort, and tips on how to find relief.
What is Vulvodynia?
Vulvodynia is a condition characterized by persistent pain felt in the vulva area, which has no clear or identifiable cause. The pain can vary in location, frequency, and intensity. It may affect women differently but almost always causes pain or discomfort during intimacy. Vulvodynia also typically comes with burning, stinging, or rawness in the vulvar region.
A vulvodynia flare lasts, on average, no less than three months but can continue for years. It is possible that it will go away on its own, but the likelihood is slim, and the chance of relapse is high. Which is why it is best to make an appointment with an ob-gyn to receive a proper diagnosis and treatment if you are exhibiting any signs of vulvodynia.
While not as common as other conditions that cause similar symptoms, studies estimate that approximately 4 to 16% of women may experience vulvodynia at some point in their lives, suggesting that it is more prevalent than one might initially think.
One of the challenges of vulvodynia is that it can be easily confused with or misdiagnosed as other conditions. Many women experiencing vulvar pain initially believe it is a urinary tract infection, yeast infection, bacterial infection, sexually transmitted infection (STI), or other gynecological issue.
What Causes Vulvodynia?
The exact cause of vulvodynia is still not fully understood and can vary from person to person, but it is not caused by an infection, nor is it contagious. As we delve deeper into potential causes later on, we’ll explore various factors that researchers have identified as potential contributors to the development of vulvodynia.
These factors include nerve abnormalities, muscle dysfunction, hormonal fluctuations, genetic predisposition, past infections or trauma, as well as exposure to allergens or irritants. Understanding these potential factors can shed light on this perplexing condition and pave the way for better management and treatment approaches.
Despite its mysterious origins, vulvodynia is a real and often debilitating condition that can significantly impact a person’s quality of life, interfere with daily activities, work, and social interactions, and destroy a woman’s sexual intercourse experience, which can lead to emotional distress, relationship difficulties, and decreased sexual satisfaction.
If you believe you are suffering from vulvodynia, chances are your symptoms will not go away on their own. You should make an appointment with an ob-gyn to receive a proper diagnosis and treatment.
Types of Vulvodynia
Vulvodynia can manifest in different forms, with two primary types being localized vulvodynia and generalized vulvodynia. Each form shares similar symptoms but has some distinct differences.
Understanding the distinction between localized and generalized vulvodynia is essential as it helps healthcare providers tailor treatment approaches and management strategies to address the specific challenges faced by individuals with each type.
Localized Vulvodynia
Localized vulvodynia refers to pain that is confined to a specific area of the vulva. This area could be a particular spot or a specific region, such as the vestibule (the entrance to the vagina) or the labia. The pain experienced in localized vulvodynia is typically characterized as a burning, stinging, or raw sensation.
Triggers or causes of localized vulvodynia can vary from person to person. Some individuals may experience symptoms after direct contact or pressure on the affected area, such as during sexual intercourse or when inserting tampons. Others may find that certain irritants, such as tight clothing, perfumed products, or specific fabrics, exacerbate their symptoms.
The intensity and frequency of symptoms can vary among individuals, but typically the symptoms of localized vulvodynia significantly impact a person’s daily life. Women with this type of vulvodynia may experience discomfort during sexual intercourse or even find it challenging to engage in prolonged sitting or other activities that put pressure on the affected area.
Generalized Vulvodynia
Generalized vulvodynia involves pain that occurs in multiple areas of the vulva rather than being limited to a specific spot. This type of vulvodynia can present with varying degrees of pain intensity, and the symptoms may be more widespread, affecting a larger portion of the vulvar region.
The symptoms associated with generalized vulvodynia are similar to those of localized vulvodynia, including burning, stinging, or rawness. Women with generalized vulvodynia may also experience heightened sensitivity to touch (known as allodynia) in the affected areas, making even gentle contact painful.
Women with generalized vulvodynia often face additional challenges due to the broader area of pain. The discomfort may not be confined to specific triggers or activities, making pinpointing what exacerbates the symptoms difficult. Consequently, individuals with generalized vulvodynia may experience ongoing discomfort throughout the day, which can significantly impact their physical and emotional well-being.
Vulvodynia Causes and Risk Factors
While the exact causes of vulvodynia remain a subject of ongoing research, several potential factors have been identified that may contribute to its development, and certain risk factors may increase a woman’s vulnerability to developing the condition.
Vulvodynia is a complex condition that may involve a combination of the following factors or other as-yet-unknown causes. Each person’s experience with vulvodynia is unique, and understanding the underlying causes can help guide treatment and management approaches tailored to the individual’s needs.
Some of the most common causes and risk factors of vulvodynia include:
Nerve Damage or Irritation
It is believed that vulvodynia may be associated with nerve dysfunction or hypersensitivity in the vulvar region. Nerves in the area may be damaged, irritated, or sending incorrect pain signals, leading to chronic pain.
Hormonal Changes
Hormonal fluctuations, particularly changes in estrogen levels, have been suggested as a possible factor in vulvodynia. Estrogen helps maintain the health and integrity of the vulvar tissues, so hormonal imbalances could potentially contribute to the development of symptoms.
Muscle Abnormalities
Dysfunction or abnormalities in the pelvic floor muscles, which provide support to the pelvic organs, may play a role in vulvodynia. Tension, spasms, or weakness in these muscles can lead to pelvic pain and discomfort, including vulvar pain.
Fetal Development
Research in the field of maternal fetal medicine is shedding light on potential origins of vulvodynia. The interplay between genetic, environmental, and developmental factors during fetal development may contribute to the risk of developing vulvodynia later in life.
Previous Chronic Pain Conditions
Women with a history of other chronic pain conditions, such as fibromyalgia or irritable bowel syndrome (IBS), may have a higher risk of developing vulvodynia.
Genetic Predisposition
There may be a genetic component to vulvodynia, as it has been observed to run in some families. Certain genetic factors may make individuals more susceptible to experiencing vulvar pain.
Previous Vaginal Infections or Trauma
Women who have experienced past vaginal or urinary tract infections or have a history of physical trauma to the pelvic area may have a higher risk of developing vulvodynia. These factors could potentially trigger or contribute to the onset of symptoms.
Allergies or Irritants
Allergies or sensitivities to certain substances, such as certain soaps, detergents, or fabrics, could irritate the vulvar area and potentially lead to vulvodynia symptoms in some individuals.
What are the Symptoms of Vulvodynia?
Vulvodynia presents a range of symptoms that can vary in intensity and duration. It’s important to note that not everyone with vulvodynia will experience all of these symptoms, and their severity can differ from person to person.
Here are some common symptoms associated with vulvodynia:
Persistent Vulvar Pain
Women with vulvodynia often experience chronic or recurrent pain in the vulvar area. The pain can manifest as a burning, stinging, or raw sensation. It may be constant or intermittent, and its intensity can range from mild discomfort to severe pain.
Discomfort During Sexual Intercourse
Vulvodynia can significantly impact sexual intercourse. Many women with vulvodynia experience pain or discomfort during penetration, making sexual activity challenging or even impossible. This can profoundly affect intimacy, sexual satisfaction, and overall quality of life.
Hypersensitivity to Touch
Individuals with vulvodynia may find that even light touch or pressure in the vulvar area triggers pain or discomfort. Activities such as wearing tight clothing, sitting for prolonged periods, or engaging in physical activities that involve contact with the vulva can exacerbate symptoms.
Vulvar Itching or Irritation
Some women with vulvodynia may also experience itching or a sense of irritation in the vulvar region, adding to their discomfort and frustration.
Is a Change in Discharge a Symptom of Vulvodynia?
Unlike conditions such as yeast infections, bacterial vaginosis, or certain STDs, vulvodynia typically does not cause any type of abnormal vaginal discharge. This distinction can help healthcare professionals differentiate vulvodynia from other similar conditions during diagnosis.
How is Vulvodynia Diagnosed?
You cannot diagnose vulvodynia at home. Reaching a diagnosis involves making an appointment with an ob-gyn for a comprehensive evaluation. An ob-gyn specializes in women’s reproductive health, including the diagnosis and treatment of conditions affecting the female genital area.
An OBGYN has the expertise to differentiate vulvodynia from other similar conditions and can work with you to develop an individualized treatment plan based on your unique needs and circumstances.
Here’s an overview of the steps typically involved in diagnosing vulvodynia:
Comprehensive Medical History
During your appointment with an obstetrics and gynecology specialist, they will begin by taking a detailed medical history. This includes discussing your symptoms, their duration and severity, any triggers or patterns you may have noticed, and any previous treatments or interventions you have tried.
Physical Examination
The next step is a physical examination, which focuses on the vulvar area. The OB-GYN will carefully examine the external genitalia for any signs of redness, swelling, or other visible abnormalities. They may perform gentle touch tests to assess your pain response and identify specific areas of tenderness or sensitivity.
While this examination can be uncomfortable, your healthcare provider will prioritize your comfort and ensure that you feel respected and supported throughout the process.
Ruling Out Other Conditions
Because vulvodynia shares symptoms with various other conditions, it’s important to rule out other potential causes for your symptoms. This may involve tests to rule out infections, skin disorders, hormonal imbalances, or other underlying medical conditions.
Your OB-GYN may perform cultures, swabs, or other diagnostic tests as needed to ensure an accurate diagnosis.
Referral to Specialists
In some cases, your OB-GYN may refer you to a specialist, such as a pelvic pain specialist, dermatologist, or urogynecologist, for further evaluation or to explore specific treatment options.
How is Vulvodynia Treated?
Once diagnosed with vulvodynia by an obstetrics and gynecology specialist, various treatment approaches can be explored to help manage the condition, reduce pain, improve quality of life, and enhance overall well-being.
Working closely with your ob-gyn and other healthcare professionals is essential to develop an individualized treatment plan tailored to your specific needs.
Some of the treatment approaches for vulvodynia might include:
Medications
Your OB-GYN may prescribe or recommend topical creams or ointments containing medications such as lidocaine or estrogen. These can provide localized pain relief and help reduce discomfort in the affected vulvar area.
In some cases, oral medications may be prescribed to help manage pain associated with vulvodynia. Examples include tricyclic antidepressants, anticonvulsants, or certain nerve pain medications. These medications work to modulate nerve signals and reduce pain sensitivity.
Physical Therapy
Physical therapy, specifically pelvic floor physical therapy, can play a crucial role in managing vulvodynia. A physical therapist with expertise in pelvic health can guide you through exercises and techniques aimed at improving pelvic floor muscle function, reducing muscle tension, and relieving pain. These may include pelvic floor relaxation exercises, stretching, biofeedback, and manual therapy techniques.
Self-Care Strategies
In addition to medical interventions, self-care strategies can complement the treatment of vulvodynia. Applying cool gel packs or sitz baths can temporarily relieve pain and discomfort. Experimenting with different temperature preferences can help determine what works best for you.
Your OBGYN might also suggest wearing loose-fitting, breathable cotton underwear and avoiding tight or synthetic fabrics that may irritate the vulvar area.
Additionally, you should attempt to identify and avoid potential irritants such as scented soaps, douches, perfumes, or harsh chemicals that could worsen symptoms.
Other Vulvodynia Treatment Options
Some individuals find relief through complementary therapies such as acupuncture, biofeedback, transcutaneous electrical nerve stimulation (TENS), mindfulness meditation, and other relaxation techniques.
While the evidence for their effectiveness may vary, these approaches have shown promise in relieving pain for some individuals and can be explored as adjunctive measures in managing symptoms.
Additionally, dealing with chronic pain conditions like vulvodynia can take a toll on mental and emotional well-being. Seeking support from a counselor or therapist experienced in chronic pain management can provide valuable coping strategies and emotional support.
Lifestyle Changes to Help Prevent Vulvodynia
Vulvodynia may not always be preventable, as its underlying causes are not completely understood. However, certain lifestyle adjustments and self-care practices may help manage symptoms and potentially reduce the risk of developing vulvodynia.
Stress Reduction Techniques
Chronic stress can exacerbate pain and discomfort, so finding effective stress reduction techniques can be beneficial. Engaging in activities such as yoga, meditation, deep breathing exercises, or mindfulness practices can help reduce stress levels and promote overall well-being.
Dietary Changes
While no specific diet has been proven to prevent or cure vulvodynia, maintaining a balanced and nutritious diet can support overall health and well-being. Some individuals find that reducing or eliminating certain potential irritants, such as spicy foods, caffeine, or acidic foods, can help alleviate vulvodynia symptoms.
Open Communication and Education
Being informed and maintaining open communication with your healthcare provider is crucial. Regular gynecological check-ups and discussions about any changes or concerns you may have can help detect and address potential issues early on. Educating yourself about vulvodynia, understanding its symptoms, and knowing when to seek medical attention can contribute to timely diagnosis and management.
Where to Get Diagnosis and Treatment for Vulvodynia, and Vaginal Pain or Discomfort in Middle Tennessee
Living with vaginal pain and discomfort isn’t something you should have to live with and is certainly something you should never brush aside. An accurate diagnosis is crucial for effectively managing vulvodynia and ruling out other possible infections or medical conditions.
If you suspect you have vulvodynia or are experiencing persistent vulvar pain or discomfort, don’t hesitate to schedule an appointment with one of our board-certified obstetrics and gynecology specialists.
Dr. Jeffrey Lodge and our caring, expert staff can provide the expertise and support you need to understand your symptoms, explore treatment options, and improve your overall well-being.