ZocdocAnswersHow does one treat vulvodynia?

Question

How does one treat vulvodynia?

I went to the gynecologist when I was in my 20's because I was experiencing a lot of vaginal pain that my doctor just ended up calling vulvodynia and saying it was nothing to worry about unless the pain got worse. Now I'm older and the pain is getting worse. Is there a good way to treat this besides taking painkillers?

Answer

Vulvodynia is a chronic pain syndrome localized to the vulva and cannot be explained by injury, infection, malignancy or any other disease. While the initial diagnosis and treatment is often made by an OBGYN, patients often seek treatment from neurologists or pain specialists. Unfortunately we do not know the cause of vulvodynia. Diseases that can cause vulvar pain include lupus, lichen sclerosus, infections with the herpes virus, yeast infections and bacterial infections. Once these have been ruled out, then the diagnosis of vulvodynia is often given. Often the chief complaint is pain with vaginal insertion of a tampon or penis. Sometimes vulvodynia is confused with another cause of painful sex called vaginismus which is a spasm of the vaginal muscles. If your main symptom is pain with insertion, then your doctor needs to rule out vaginismus as the cause. Treatments for vulvodynia are to avoid irritation of the area by wearing cotton underwear and undergoing physical therapy. Some physicians choose special pain medicines for neuropathic pain syndromes and some patients do get good relief. Nerve injections and surgery are last resorts. I suggest that you schedule an appointment your OBGYN for another full consultation. I think it is important that you make sure that there are no other treatable causes for your pain. Once all the other causes have definitively been ruled out, then you can proceed with some of the treatment options.

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