Chapter 1: Introduction to Vulvodynia
Explaining what vulvodynia is and how it affects women.
Vulvodynia is a chronic pain condition that affects women. It is characterized by persistent, unexplained pain in the vulva, which is the external female genitalia. The pain may be experienced as burning, stinging, or sharp. It can also be accompanied by itching or soreness.
The exact cause of vulvodynia is not fully understood, but it is believed to be related to the nerves in the vulva. Some researchers think that vulvodynia may be caused by nerve damage or irritation, while others believe it may be due to changes in the way the nerves respond to pain signals.
Vulvodynia can have a significant impact on a woman's quality of life. The pain can be so severe that it can make it difficult to sit, exercise, or have sexual intercourse. Women with vulvodynia may also experience anxiety and depression, as well as a sense of isolation and shame.
There are two main types of vulvodynia: generalized and localized. Generalized vulvodynia involves pain that is felt in the entire vulvar area, while localized vulvodynia is limited to a specific area, such as the vestibule, clitoris, or labia.
Vulvodynia is a common condition, but it is often underdiagnosed and undertreated. Some women may be hesitant to talk about their symptoms with their healthcare provider, out of embarrassment or fear of being dismissed. However, it is important to seek medical attention if you are experiencing vulvar pain, as there are treatments available that can help manage the symptoms.
Vulvodynia is a chronic pain condition that affects women and can have a significant impact on their quality of life. It is important for women to be aware of the symptoms of vulvodynia and to seek medical attention if they are experiencing vulvar pain. With proper diagnosis and treatment, many women with vulvodynia can find relief from their symptoms and improve their overall quality of life.
References
Harlow BL, Stewart EG. A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia? J Am Med Womens Assoc. 2003;58(2):82-88.
Reed BD, Harlow SD, Sen A, et al. Relationship between vulvodynia and chronic comorbid pain conditions. Obstet Gynecol. 2012;120(1):145-151. doi:10.1097/AOG.0b013e31825d20f9
Haefner HK. Report of the International Society for the Study of Vulvovaginal Disease—classification of vulvodynia. J Low Genit Tract Dis. 2007;11(1):48-49. doi:10.1097/01.lgt.0000245099.51779.96
Pukall CF, Goldstein AT, Bergeron S, et al. Vulvodynia: definition, prevalence, impact, and pathophysiological factors. J Sex Med. 2016;13(3):291-304. doi:10.1016/j.jsxm.2015.12.016
Moyal-Barracco M, Lynch PJ. 2014 ISSVD, ISSWSH and IPPS consensus terminology and classification of persistent vulvar pain and vulvodynia. J Low Genit Tract Dis. 2016;20(2):126-130. doi:10.1097/LGT.0000000000000181
Chapter 2: Symptoms of Vulvodynia
Vulvodynia is a complex condition that can cause a wide range of symptoms, making it difficult to diagnose and treat. The most common symptom of vulvodynia is chronic pain in the vulva, which can be described as a burning, stinging, or raw sensation. The pain may be constant or intermittent, and it can range from mild to severe.
In addition to pain, women with vulvodynia may experience other symptoms, including:
Burning or itching in the vulva
Pain during intercourse (dyspareunia)
Pain during urination (dysuria)
Swelling or inflammation of the vulva
Redness or discoloration of the vulva
Soreness or tenderness of the vulva
These symptoms can vary from woman to woman and may change over time. Some women may experience only one or two symptoms, while others may have multiple symptoms that affect their daily lives.
It is important to note that vulvodynia is a chronic condition, meaning that the symptoms can last for months or even years. This can lead to significant physical and emotional distress for women, affecting their ability to work, exercise, and engage in sexual activity.
In some cases, women with vulvodynia may also experience associated symptoms, such as anxiety, depression, and sleep disturbances. These symptoms can further exacerbate the impact of vulvodynia on a woman's quality of life.
Overall, the symptoms of vulvodynia can be diverse and complex, and it is important for women to seek medical attention if they experience any of these symptoms. A healthcare provider can perform an evaluation and recommend appropriate treatments to help manage the symptoms and improve a woman's quality of life.
References
Harlow BL, Kunitz CG, Nguyen RHN, Rydell SA, Turner RM, MacLehose RF. Prevalence of Symptoms Consistent with a Diagnosis of Vulvodynia: Population-Based Estimates from 2 Geographically Defined Cohorts. J Low Genit Tract Dis. 2014;18(1):28-35. doi: 10.1097/LGT.0b013e3182873b7c.
Reed BD, Harlow SD, Sen A, et al. Relationship Between Vulvodynia and Chronic Comorbid Pain Conditions. Obstet Gynecol. 2012;120(1):145-151. doi: 10.1097/AOG.0b013e31825d60ce.
Moyal-Barracco M, Lynch PJ. 2010 ISSVD Terminology and Classification of Vulvodynia: A Historical Perspective. J Reprod Med. 2014;59(3-4):103-109.
Stewart EG, Spencer CR. Vulvodynia. Obstet Gynecol Clin North Am. 2017;44(3):381-394. doi: 10.1016/j.ogc.2017.04.007.
Bornstein J, Goldstein AT, Stockdale CK, et al. 2015 ISSVD, ISSWSH, and IPPS Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia. Obstet Gynecol. 2016;127(4):745-751. doi: 10.1097/AOG.0000000000001353.
Chapter 3: Types of Vulvodynia
Vulvodynia is a complex and often poorly understood condition characterized by chronic pain in the vulvar region of the female genitalia. There are several different types of vulvodynia, each with its own unique set of symptoms and causes. In this chapter, we will explore the two main types of vulvodynia: generalized vulvodynia and localized vulvodynia.
Generalized Vulvodynia
Generalized vulvodynia, also known as vulvar vestibulitis syndrome (VVS), is characterized by pain throughout the entire vulvar region. Women with generalized vulvodynia may experience pain during sexual activity, as well as during everyday activities such as sitting or wearing tight clothing. The pain may be described as burning, stinging, or raw, and may be constant or intermittent.
The exact cause of generalized vulvodynia is not known, but it is thought to be related to a combination of factors, including nerve damage, hormonal imbalances, and a history of sexual trauma. Women with generalized vulvodynia may also experience other symptoms, such as itching, swelling, and redness in the vulvar region.
Localized Vulvodynia
Localized vulvodynia, also known as vulvar vestibulitis or vestibular papillomatosis, is characterized by pain that is localized to a specific area of the vulva, such as the vestibule or the labia minora. Women with localized vulvodynia may experience pain during sexual activity, as well as during everyday activities such as sitting or wearing tight clothing. The pain may be described as burning, stinging, or raw, and may be constant or intermittent.
The exact cause of localized vulvodynia is not known, but it is thought to be related to nerve damage, inflammation, or irritation in the affected area. Women with localized vulvodynia may also experience other symptoms, such as itching, swelling, and redness in the affected area.
Vulvodynia is a complex condition that can be difficult to diagnose and treat. Understanding the different types of vulvodynia is an important first step in developing an effective treatment plan. Women who experience chronic pain in the vulvar region should consult with a healthcare provider who specializes in the diagnosis and treatment of vulvodynia. With proper diagnosis and treatment, many women are able to find relief from the pain and discomfort associated with this condition.
References
Stewart, E. G., & Bergeron, S. (2018). Vulvodynia. Women's Health, 14, 1-8. doi: 10.1177/1745505718806168
Arnold, L. D., Bachmann, G. A., Rosen, R., Kelly, S., & Rhoads, G. G. (2007). Vulvodynia: Characteristics and associations with comorbidities and quality of life. Obstetrics and Gynecology, 109(2), 418-424. doi: 10.1097/01.AOG.0000252709.28964.5d
Haefner, H. K. (2011). Vulvodynia: What we know and where we should be going. Journal of Lower Genital Tract Disease, 15(3), 167-171. doi: 10.1097/LGT.0b013e31821b7038
Bornstein, J., Goldstein, A. T., Stockdale, C. K., Bergeron, S., Pukall, C., Zolnoun, D., ... & Bachmann, G. (2016). 2015 ISSVD, ISSWSH and IPPS consensus terminology and classification of persistent vulvar pain and vulvodynia. Obstetrics and Gynecology, 127(4), 745-751. doi: 10.1097/AOG.0000000000001357
Chapter 4: Causes of Vulvodynia
Vulvodynia is a complex condition with no known single cause. It is often referred to as a chronic pain disorder that affects the vulva, the external genital area of a woman's body. The exact cause or causes of vulvodynia are not fully understood, but several factors have been identified as potential contributors to the development of this condition.
One possible cause of vulvodynia is nerve damage or irritation. In some women, the nerves in the vulva may become damaged or irritated, leading to chronic pain. This damage or irritation can be caused by a variety of factors, including injury, surgery, infections, or chronic inflammation.
Another possible cause of vulvodynia is hormonal imbalances. Hormonal changes, such as those that occur during menopause or pregnancy, can lead to changes in the tissues of the vulva, which can result in pain and discomfort.
Pelvic floor dysfunction is also a possible cause of vulvodynia. The pelvic floor muscles, which support the pelvic organs and help control bladder and bowel function, can become weak or tense. This can lead to pain and discomfort in the vulva and surrounding areas.
Other potential causes of vulvodynia include genetics, autoimmune disorders, allergies, and psychological factors such as anxiety and depression. It is important to note that vulvodynia is a complex condition, and often, multiple factors may be involved in its development.
While the exact cause or causes of vulvodynia are not fully understood, research into this condition is ongoing. Understanding the underlying mechanisms of vulvodynia is critical to developing effective treatments and improving the quality of life for women who suffer from this condition.
References:
Bornstein, J., Goldstein, A. T., Stockdale, C. K., Bergeron, S., Pukall, C., Zolnoun, D., ... & Bachmann, G. (2016). 2015 ISSVD, ISSWSH and IPPS consensus terminology and classification of persistent vulvar pain and vulvodynia. Obstetrics and gynecology, 127(4), 745-751.
Reed, B. D., Harlow, S. D., Sen, A., Edwards, R. M., Chen, D., & Haefner, H. K. (2012). Relationship between vulvodynia and chronic comorbid pain conditions. Obstetrics and gynecology, 120(1), 145-151.
Bohm-Starke, N. (2014). Medical and physical factors associated with vulvodynia. Current opinion in obstetrics & gynecology, 26(5), 422-427.
Pukall, C. F., Goldstein, A. T., Bergeron, S., Foster, D., Stein, A., Kellogg-Spadt, S., ... & Bachmann, G. (2016). Vulvodynia: Definition, prevalence, impact, and pathophysiological factors. Journal of sex research, 53(3), 337-352.
Chapter 5: Diagnosing Vulvodynia
Vulvodynia is a condition that causes chronic pain in the vulva, which is the external genitalia of the female body. The condition can be difficult to diagnose as there are no specific tests to confirm the presence of the condition. However, a thorough diagnostic process is essential to rule out other possible causes of pain and discomfort in the vulva.
The diagnostic process for vulvodynia begins with a comprehensive medical history. The doctor will ask about symptoms, including the type of pain experienced, the duration of the pain, and any factors that may worsen or alleviate the pain. They may also ask about medical history, sexual history, and any medications or treatments that have been tried previously.
After taking a medical history, the doctor will perform a physical examination. The physical examination may include a visual inspection of the vulva and surrounding tissues to look for signs of inflammation, infection, or injury. In some cases, a speculum may be used to help the doctor see the inside of the vagina more clearly. The doctor may also use a cotton swab to apply pressure to different areas of the vulva to determine the location and severity of the pain.
In addition to a physical examination, additional testing may be necessary to rule out other possible causes of vulvar pain. This may include swabs to test for infections, a biopsy of vulvar tissue to check for abnormalities or cancer, or imaging tests to evaluate the pelvic region.
The diagnosis of vulvodynia is based on a combination of the medical history, physical examination, and ruling out other possible causes of vulvar pain. Once other causes of vulvar pain have been ruled out, the diagnosis of vulvodynia is made based on the presence of chronic vulvar pain with no identifiable cause.
It is important to undergo a thorough diagnostic process for vulvodynia to receive an accurate diagnosis and begin appropriate treatment. Treatment options may include medications, nerve blocks, physical therapy, or surgery. In addition to medical treatment, lifestyle changes such as stress reduction and changes in sexual practices may also help to reduce symptoms.
Vulvodynia is a chronic pain condition that affects the vulva and can be difficult to diagnose. A thorough diagnostic process that includes a medical history, physical examination, and additional testing to rule out other possible causes of vulvar pain is essential to receive an accurate diagnosis and begin appropriate treatment. If you are experiencing chronic vulvar pain, be sure to speak with your healthcare provider to begin the diagnostic process.
References
Haefner, H. K. (2003). Report of the International Society for the Study of Vulvovaginal Disease on the current terminology of vulvodynia. Journal of lower genital tract disease, 7(2), 82-84.
Bornstein, J., Goldstein, A. T., Stockdale, C. K., Bergeron, S., Pukall, C., Zolnoun, D., & Coady, D. (2016). 2015 ISSVD, ISSWSH, and IPPS consensus terminology and classification of persistent vulvar pain and vulvodynia. Journal of lower genital tract disease, 20(3), 126-130.
Reed, B. D., Harlow, S. D., Sen, A., & Edwards, R. M. (2012). Relationship between vulvodynia and chronic comorbid pain conditions. Obstetrics & Gynecology, 120(1), 145-151.
Pukall, C. F., Goldstein, A. T., Bergeron, S., Foster, D., Stein, A., Kellogg-Spadt, S., & Bachmann, G. (2016). Vulvodynia: definition, prevalence, impact, and pathophysiological factors. Journal of sexual medicine, 13(3), 291-304.
Reed, B. D., Crawford, S., Couper, M., Cave, C., & Haefner, H. K. (2004). Pain at the vulvar vestibule: a web‐based survey. Journal of lower genital tract disease, 8(1), 48-57.
Chapter 6: Treatment Options for Vulvodynia
Vulvodynia is a chronic pain condition affecting the vulva, which can be difficult to manage. Treatment options may vary based on the underlying cause of the pain and the individual's specific symptoms. Here are some common treatment options for vulvodynia:
Medication: A variety of medications may be prescribed to help alleviate the pain associated with vulvodynia. These may include topical creams or ointments, oral medications such as antidepressants or anticonvulsants, or nerve blocks to numb the area.
Physical therapy: Pelvic floor physical therapy is a type of therapy that can be used to treat vulvodynia. This involves exercises to help relax the muscles of the pelvic floor, which can help to reduce pain and discomfort.
Lifestyle changes: Making changes to your lifestyle can also be helpful in managing vulvodynia. These changes may include avoiding tight-fitting clothing, using fragrance-free or hypoallergenic products, and avoiding activities that can exacerbate symptoms, such as riding a bike or using a tampon.
Surgery: In some cases, surgery may be recommended as a treatment for vulvodynia. This may include the removal of the affected tissue, or other procedures to help alleviate pain.
Cognitive-behavioral therapy (CBT): CBT is a type of therapy that can be used to help manage chronic pain conditions such as vulvodynia. This therapy helps patients identify and change negative thought patterns, which can help to reduce pain and improve overall well-being.
Complementary therapies: There are a variety of complementary therapies that can be used to help manage the symptoms of vulvodynia. These may include acupuncture, massage therapy, or herbal remedies. It is important to discuss the use of complementary therapies with your healthcare provider before starting any new treatments.
The treatment options for vulvodynia may vary based on the underlying cause of the pain and the individual's specific symptoms. Medication, physical therapy, lifestyle changes, surgery, cognitive-behavioral therapy, and complementary therapies are all potential treatment options for vulvodynia. It is important to work closely with your healthcare provider to develop a treatment plan that is tailored to your individual needs and goals.
References
Foster, R. T., & Handa, V. L. (2013). Management of vulvodynia. International journal of women's health, 5, 437-449.
Goetsch, M. F. (2018). Vulvodynia: diagnosis and management. American family physician, 97(8), 505-512.
Pukall, C. F., & Goldstein, A. T. (2016). Vulvodynia: A state-of-the-art consensus on definitions, diagnosis and management. Journal of obstetrics and gynaecology Canada, 38(5), 489-491.
Reed, B. D., Harlow, S. D., Sen, A., & Edwards, R. M. (2012). Relationship between vulvodynia and chronic comorbid pain conditions. Obstetrics & Gynecology, 120(1), 145-151.
Stewart, E. G., & Bergeron, S. (2017). Vulvodynia: diagnosis and management. Journal of psychosomatic obstetrics & gynecology, 38(4), 265-275.
Tomaszewski, E. L., & Helgeson, E. S. (2019). Treatment of vulvodynia. Current opinion in obstetrics and gynecology, 31(6), 481-487.
Chapter 7: Medications for Vulvodynia
Vulvodynia is a chronic pain condition that affects the vulva, which can be difficult to manage. There are a variety of medications that can be used to help alleviate the pain associated with vulvodynia. Here are some common medications that may be prescribed:
Topical creams and ointments: Topical creams and ointments are often the first line of treatment for vulvodynia. These medications are applied directly to the affected area and can help to reduce inflammation and relieve pain. Common topical medications include lidocaine, estrogen creams, and corticosteroids.
Oral medications: In some cases, oral medications may be prescribed to help manage vulvodynia. These medications may include antidepressants, anticonvulsants, or muscle relaxants. Antidepressants such as tricyclics and selective serotonin reuptake inhibitors (SSRIs) are often prescribed to help manage chronic pain conditions, including vulvodynia. Anticonvulsants such as gabapentin and pregabalin can also be effective in reducing pain and discomfort.
Nerve blocks: In some cases, nerve blocks may be used to help manage the pain associated with vulvodynia. This involves injecting a local anesthetic into the nerves that supply the affected area, which can help to numb the pain.
It is important to note that medications may not work for everyone and that individual responses can vary. Additionally, some medications may cause side effects, so it is important to work closely with your healthcare provider to determine the best treatment plan for your individual needs and goals.
There are a variety of medications that can be used to help manage vulvodynia, including topical creams, oral medications, and nerve blocks. It is important to work closely with your healthcare provider to determine the best treatment plan for your individual needs and goals. Additionally, it is important to follow your healthcare provider's instructions carefully and to report any side effects or changes in symptoms.
References
Arnold, L. D., Bachmann, G. A., & Kelly, S. (2017). Vulvodynia: diagnosis and management. American family physician, 95(12), 770-776.
Bergeron, S., Binik, Y. M., Khalifé, S., Pagidas, K., & Glazer, H. I. (2001). Vulvar vestibulitis syndrome: reliability of diagnosis and evaluation of current diagnostic criteria. Obstetrics & Gynecology, 98(1), 45-51.
Bohm-Starke, N. (2014). Medical and physical predictors of localized provoked vulvodynia. Acta Obstetricia et Gynecologica Scandinavica, 93(6), 557-562.
Harlow, B. L., & Stewart, E. G. (2003). A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia?. Journal of the American Medical Women's Association (1972), 58(2), 82-88.
Pukall, C. F., & Goldstein, A. T. (2016). Vulvodynia: A state-of-the-art consensus on definitions, diagnosis and management. Journal of obstetrics and gynaecology Canada, 38(5), 489-491.
Reed, B. D., Harlow, S. D., Sen, A., & Edwards, R. M. (2012). Relationship between vulvodynia and chronic comorbid pain conditions. Obstetrics & Gynecology, 120(1), 145-151.
Chapter 8: Non-Medication Treatments for Vulvodynia
While medication can be effective in managing vulvodynia, some individuals may prefer non-medication treatments or may not respond well to medication. Here are some non-medication treatments that may be helpful for managing vulvodynia:
Pelvic floor therapy: Pelvic floor therapy involves working with a physical therapist who specializes in treating pelvic floor dysfunction. The therapist may use a variety of techniques, such as pelvic floor exercises, trigger point release, and biofeedback, to help reduce pain and discomfort.
Acupuncture: Acupuncture involves the insertion of thin needles into specific points on the body to help alleviate pain and discomfort. While more research is needed to determine the effectiveness of acupuncture for vulvodynia, some individuals have reported improvement in symptoms with this treatment.
Biofeedback: Biofeedback is a technique that involves using electronic sensors to monitor and provide feedback on bodily functions, such as muscle tension and heart rate. This can help individuals learn how to relax their muscles and reduce pain and discomfort.
Cognitive behavioral therapy (CBT): CBT is a type of talk therapy that focuses on changing negative thought patterns and behaviors that may be contributing to pain and discomfort. This can be particularly helpful for individuals with vulvodynia who are experiencing anxiety or depression related to their condition.
It is important to note that non-medication treatments may not work for everyone and that individual responses can vary. Additionally, some treatments may take time to be effective and may require ongoing sessions or appointments. It is important to work closely with your healthcare provider and/or a qualified practitioner to determine the best treatment plan for your individual needs and goals.
There are a variety of non-medication treatments that can be used to help manage vulvodynia, including pelvic floor therapy, acupuncture, biofeedback, and cognitive behavioral therapy. It is important to work closely with your healthcare provider and/or a qualified practitioner to determine the best treatment plan for your individual needs and goals. Additionally, it is important to follow your healthcare provider's instructions carefully and to report any changes in symptoms or side effects.
References
Bachmann, G. A., & Rosen, R. (2017). Vulvodynia: a state-of-the-art consensus on definitions, diagnosis and management. American Journal of Obstetrics and Gynecology, 216(1), 1-12.
Bergeron, S., Binik, Y. M., Khalifé, S., Pagidas, K., & Glazer, H. I. (2001). Vulvar vestibulitis syndrome: reliability of diagnosis and evaluation of current diagnostic criteria. Obstetrics & Gynecology, 98(1), 45-51.
Goldfinger, C., Pukall, C. F., & Gentilcore-Saulnier, E. (2017). Pelvic floor muscle therapy for vulvar vestibulitis syndrome. Journal of Sex & Marital Therapy, 43(8), 753-764.
Glazer, H. I. (1995). Treatment of vulvar vestibulitis syndrome with electromyographic biofeedback of pelvic floor musculature. Journal of Reproductive Medicine, 40(4), 283-290.
Lee, S. H., & Yang, G. Y. (2014). Meta-analysis of acupuncture for relieving nonorganic dyspareunia. Journal of Alternative and Complementary Medicine, 20(9), 689-694.
Reed, B. D., Harlow, S. D., Sen, A., & Edwards, R. M. (2012). Relationship between vulvodynia and chronic comorbid pain conditions. Obstetrics & Gynecology, 120(1), 145-151.
Zolnoun, D. A. (2018). Chronic pelvic pain in women: diagnostic and therapeutic approach. American Family Physician, 97(12), 785-793.
Chapter 9: Coping with Vulvodynia
Living with vulvodynia can be challenging both physically and emotionally. It can impact your daily life, relationships, and self-esteem. While there is no one-size-fits-all approach to coping with vulvodynia, there are some tips and strategies that may help you manage the condition and improve your quality of life.
Educate yourself: Learning about vulvodynia can help you better understand the condition, its symptoms, and available treatments. It can also help you communicate more effectively with your healthcare provider and advocate for your own care.
Find a healthcare provider who specializes in vulvodynia: Seek out a healthcare provider who has experience diagnosing and treating vulvodynia. They can help you identify the best treatment options for your individual needs.
Practice self-care: Taking care of yourself physically and emotionally is important when living with vulvodynia. Engage in activities that bring you joy and relaxation, such as yoga, meditation, or listening to music.
Use lubricants during sexual activity: Using a water-based lubricant during sexual activity can help reduce friction and discomfort.
Seek support: Joining a support group for women with vulvodynia can help you connect with others who are going through similar experiences. It can also provide a safe space to share your thoughts and feelings.
Consider counseling: Living with vulvodynia can be emotionally challenging. Counseling can help you develop coping strategies and improve your emotional well-being.
Communicate with your partner: It is important to communicate openly and honestly with your partner about vulvodynia and how it affects your sex life. Together, you can explore alternative ways of being intimate and finding pleasure.
Practice good hygiene: Good hygiene can help prevent irritation and infection. Avoid using harsh soaps, perfumes, or other irritants in the genital area.
Be patient: Vulvodynia can be a complex and frustrating condition. It may take time to find the right treatment approach for you. Be patient with yourself and with the process.
References
Sadownik LA, Seal BN. Vulvodynia: diagnosis and management. J Obstet Gynaecol Can. 2014 Apr;36(4):266-74. doi: 10.1016/s1701-2163(15)30668-9. PMID: 24703369.
Reed BD, Harlow SD, Sen A, Edwards RM, Chen D, Haefner HK. Relationship between vulvodynia and chronic comorbid pain conditions. Obstet Gynecol. 2012 Dec;120(6):145-51. doi: 10.1097/AOG.0b013e318273eb1a. PMID: 23168754; PMCID: PMC3574429.
National Vulvodynia Association. Coping Strategies. Available at: https://www.nva.org/living-with-vulvodynia/coping-strategies/. Accessed on May 2, 2023.
Andrews JC, Lesher JL. Management of vulvodynia: pharmacologic and nonpharmacologic therapies. Am J Clin Dermatol. 2015 Jun;16(3):163-77. doi: 10.1007/s40257-015-0126-4. PMID: 25921538.
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Chapter 10: Prevention and Self-Care for Vulvodynia
Vulvodynia is a chronic pain condition affecting the vulva and surrounding areas, which can have a significant impact on a person's quality of life. While there is no surefire way to prevent vulvodynia, there are some self-care practices that can help manage symptoms and promote overall vulvar health.
Practice good hygiene: Good hygiene is essential to prevent infections that can cause vulvar irritation and pain. Avoid using harsh soaps, perfumes, or other products that can irritate the vulva. Use warm water to wash the area and pat dry with a clean towel. Avoid using hot water or rubbing the area with a towel.
Wear loose-fitting clothing: Tight clothing, such as tight jeans or leggings, can cause friction and irritation, leading to pain and discomfort. Opt for loose-fitting clothing made from breathable materials such as cotton to reduce irritation.
Avoid irritants: Avoid using products that contain potential irritants such as dyes, fragrances, or preservatives. These can irritate the sensitive skin in the vulvar area and cause pain and discomfort.
Manage stress: Stress can exacerbate symptoms of vulvodynia. Try to find ways to manage stress such as deep breathing, yoga, meditation, or talking to a therapist.
Use lubrication: Using a water-based lubricant during sexual activity can reduce friction and prevent pain and discomfort. Avoid using products that contain perfumes, dyes, or other potential irritants.
Try pelvic floor exercises: Pelvic floor exercises, also known as Kegels, can help improve muscle tone and reduce pain and discomfort. Consult with a physical therapist or healthcare provider for guidance on performing these exercises correctly.
Experiment with alternative therapies: Some alternative therapies such as acupuncture, biofeedback, or massage therapy may help manage symptoms of vulvodynia. Consult with a healthcare provider to determine if these therapies may be appropriate for you.
While these self-care practices may help manage symptoms of vulvodynia, it is important to seek medical attention if you experience persistent pain or discomfort in the vulvar area. A healthcare provider can help determine the underlying cause of the pain and provide appropriate treatment options.
References
Graziottin, A., & Murina, F. (2018). Vulvodynia: A new conceptual framework. Journal of psychosomatic obstetrics and gynaecology, 39(4), 257-267.
Arnold, L. D., Bachmann, G. A., Kelly, S., Rosen, R., & Rhoads, G. G. (2006). Vulvodynia: characteristics and associations with comorbidities and quality of life. Obstetrics and gynecology, 107(3), 617-624.
Reed, B. D. (2018). Vulvodynia. Obstetrics and gynecology, 131(1), 185-200.
Masheb, R. M., & Faghri, P. D. (2014). Pelvic floor muscle function in women with vulvodynia: a case-control study. The Journal of Sexual Medicine, 11(1), 272-279.
Bachmann, G. A. (2014). Management of patients with vulvodynia. Drugs, 74(3), 267-279.
