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Question
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I heard a lecture the other day in which a sex therapist mentioned the vaginal pain condition vulvodynia.
Can you give me a better idea of what this is? I think I may have it.
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Answer
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Vulvodynia describes a variety of conditions related to pain in the vulva area (i.e., the external part of the
female genitalia including the outer and inner lips, the vestibule surrounds the opening of the vagina and the
urethra, the perineum which is the area between the bottom of the vulva and the anus). It is usually characterized
by burning, stinging, irritation or rawness of the vulva in cases in which there is no infection or skin disease of
the vulva or vagina causing these symptoms. The name vulvodynia, (Greek for "vulvar pain") was coined in the 1980s
as an umbrella term for all vulvar diseases, including infections and vaginal atrophy at menopause -- conditions
which have known causes and are treatable.
Past research literature focused almost exclusively on painful sexual intercourse as the primary symptom of vulvar pain.
In real life, women have reported a wide variety of physical symptoms including: itching, stinging, burning, shooting pains,
hypersensitivity and sensations of dryness or swelling anywhere in the vulvar skin -- including the vaginal opening, the
outer and inner vaginal lips, and clitoris.
Some researchers indicate that women with this condition are sometimes unable to wear underwear, tailored pants or jeans
because fabric touching and pulling the skin and pubic hair is uncomfortable and even downright painful.
A variety of surgical and pharmacological treatments (steroids, antibiotic, antifungal, and antiviral medications) have
been tried -- with little success. Pain management therapies for chronic pain, such as tricyclic antidepressants, antiseizure
drugs, and nerve blocks have also been tried; but they generally provide, at best, only inadequate or temporary relief.
Some strategies that have reduced the discomfort include:
- Taking baths (sitz or tub) in lukewarm, plain water several times a day.
- Rinsing the vulvar skin after every urination with a squirt bottle, bidet, or shower head.
- Rinsing all detergent out of underwear by putting it through the wash cycle repeatedly with plain water only.
- Avoiding fabric softener in the washer or dryer.
- Using 100 percent cotton menstrual pads and tampons, or rolls of pure cotton, instead of commercial pads and tampons.
- Wearing 100 percent cotton underwear and stockings -- no pantyhose.
- Avoiding chlorinated pools or hot tubs.
- Using topical estrogen creams.
- Local anesthetics (i.e. lidocaine)
As you can imagine, living with this condition can have a significant effect on the way that a woman feels about herself sexually,
as well as her relationships with others. It's important to find support for yourself and talk with your partners(s) about this
condition.
It is possible to maintain a satisfying sexual life with this type of condition -- it may simply take a little more planning and a
lot of communication.
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Best,
Dr. Sandor Gardos
MyPleasure provides up-to-date and useful sexual education materials in combination
with a store that allows people to buy, try, and learn about new aspects of
sexuality. We believe everybody deserves a great sex life.
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