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Question
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.


Answer
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.


Best,
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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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