7 symptoms of vulvodynia and main forms of treatment

Vulvodynia affects many women, causing discomfort and intense pain that can impair quality of life. In addition, the disease is hardly diagnosed, which can prolong symptoms. The gynecologist Dr. Regina Amarante (CRM 142513), from the São Camilo SP Hospital Network, explained what this clinical condition is, mentioned the symptoms and forms of treatment. Check out!

What is vulvodynia?

According to the professional, vulvodynia (VD) is defined as vulvar pain that lasts at least three months. “It is a complex, multifactorial clinical condition with intense pain that occurs in the absence of visible infectious, inflammatory, neoplastic, or neurological findings.” In addition, the specialist clarified that the disease is not sexually transmitted.

causes of vulvodynia

Dr. Regina reported that vulvodynia has no clear identifiable cause, however several factors may be associated with its origin, such as:

• Comorbidities and other pain syndromes, such as painful bladder syndrome, fibromyalgia, irritable bowel syndrome, and temporomandibular disorders;
• Genetic predisposition that increases the risk of candidiasis and other infections;
• Genetic changes that allow exaggerated or prolonged inflammatory responses;
• Increased susceptibility to hormonal changes associated with the use of hormonal contraceptives;
• The use of combined hormonal contraceptives may increase the risk of developing vulvodynia;
• Musculoskeletal disorders such as pelvic muscle hyperactivity, myofascial and biomechanical;
• Neurological mechanisms and neuroproliferation;
• Inflammation and psychosocial factors such as anxiety, depression, childhood victimization and post-traumatic stress also contribute to the development of vulvodynia.

As seen, the possible causes of the disease are diverse, so it is important to seek medical help to evaluate each case.

How to detect vulvodynia and main symptoms

The gynecologist reported that “the diagnosis of vulvodynia is one of exclusion, it includes a detailed anamnesis and tests to rule out organic causes. In most cases, the vulvoscopy exam does not detect abnormalities and the histology is usually inconclusive, which does not help to clarify the diagnosis”. Below are the main symptoms cited by the specialist:

• Pain in the vulva or a lot of sensitivity in the female genital region;
• Intense discomfort to the touch;
• Irritation, itching or burning in the vulvar area;
• Sensation of heat in the vulva;
• Difficulty or pain during sexual intercourse;
• Discomfort when inserting tampon or menstrual cups into the vagina;
• Stitches in the vulva.

Dr. Regina pointed out that “most patients with vulvodynia have their diagnosis delayed, often for years, and also because of the gynecologists’ lack of knowledge about the disease”.

How to treat vulvodynia

The gynecologist reported that treatment is usually carried out with the use of tricyclic antidepressants, topical or oral estrogen therapy and topical sedatives to decrease the severity of symptoms. In addition, the professional said that 30 minutes before intercourse you can apply “lubricants and topical anesthetics, such as 2% to 5% lidocaine gel and reapply during the act. If there is pain during the day, she can also apply the anesthetic substance.”

Another doctor’s advice is to “use neutral products and white cotton underwear, avoid silicone or oily lubricants and give preference to water-based moisturizers.” Also, maintain a “diet low in oxalates – residues of some foods excreted in the urine as crystals that when in contact with the vulva cause irritation”. To help reduce urinary oxalate levels, it is recommended to ingest “1,200 mg of calcium citrate daily,” he added.

In cases where the patient does not respond to traditional treatment, the gynecologist informed that focal excisions, vestibuloplasty, perineoplasty or vestibulectomy can be performed. However, neural hyperplasia removal surgery “is not indicated when there is generalized and unprovoked pain”.

In addition to the treatment options mentioned, some doctors may indicate the application of botulinum toxin, local physical therapy and fractional CO2 laser treatment. Enjoy and learn more about vaginal fissure and how to treat this nuisance that affects so many women!

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.