Introduction

Vulvodynia is a misunderstood condition that involves chronic pain in the vulvar region without an apparent cause. It impacts both physical and mental health, causing significant emotional distress. 

Vulvodynia is more than just a medical condition that is rarely discussed in medical textbooks. It has a profound psychological impact on the psyches of those who struggle with it. 

This blog explores the causes, symptoms, diagnosis, and treatment options, highlighting the profound psychological effects on those affected.

Understanding Vulvodynia

Vulvodynia is the presence of persistent, unexplained discomfort in the vulva, vagina, or genital region.

Pain in the vulvar and vagina are common symptoms of a variety of conditions, like skin disorders and infections.

Vulvodynia is an anomaly. Vulvodynia is discomfort that persists for at least three months without being conspicuously indicative of a particular ailment. The pain may be so severe that it prevents you from engaging in sexual activities.

Types of Vulvodynia

Vulvodynia affects the vulva and the external female genital organs, including the labia, clitoris, and vaginal opening.

There are two primary types:

Generalized vulvodynia: It causes pain in various vulvar areas at different times. Vulvar pain can be constant or intermittent. Sensations of touch or pressure may or may not trigger it, but more often than not, they exacerbate the pain.

Localized vulvodynia: It results in pain in a specific area of the vulva. Typically characterized by a burning sensation, this type of vulvar pain is often provoked by touch or pressure, such as during sexual activity or prolonged sitting.

Causes of Vulvodynia

The exact cause of vulvodynia is unknown, but researchers believe several factors may contribute to its development.

Here are some potential causes:

Nerve problems: Damage or inflammation of the nerves in the vulva can result in misinterpretation or intensification of pain signals, causing vulvodynia.

Muscle problems: Pelvic floor muscle spasms or weakness can cause vulvar pain.

Skin irritation: Harsh soaps, detergents, fragrances, or even tight clothing can irritate the vulva and trigger pain.

Vaginal infections: Recurrent yeast infections, bacterial vaginosis, or lichen sclerosus can be linked to vulvodynia.

Changes in hormone levels: Fluctuations in estrogen levels, such as those that occur during menopause or after childbirth, may play a role in some cases.

Psychological factors: Stress, worry, and depression can exacerbate symptoms of vulvodynia, and certain studies indicate they may also play a role as contributory factors in some instances.

Symptoms of Vulvodynia

Symptoms of vulvodynia may include:

• Burning, stinging, or rawness
• Aching, soreness, or throbbing
• Itching
• Sharp, stabbing pain
• Increased sensitivity to touch
• Pain during sexual intercourse, tampon insertion, or wearing tight clothing 

Note: Pain may move around or always be in the same place. It can be constant, or it can come and go.

The Psychological Impact of Vulvodynia

Vulvodynia can also have a wide range of psychological impacts.

Sexual Dysfunction: Vulvodynia can result in uncomfortable sexual experiences which can cause a decline in sexual arousal, libido, satisfaction, and closeness. This decline in sexual function can strain relationships, causing emotional distance and reducing overall closeness with partners.

Sleep disturbances: Vulvodynia is one chronic pain condition that can cause problems sleeping. Women who experience discomfort or pain may find it difficult to obtain a good night's sleep, which can further affect emotional and psychological well-being, leading to increased stress and decreased mental health.

Effects on the mind and emotions: Having chronic pain can have a negative effect on one's mental state. Vulvodynia can cause stress, worry, and depression in women. Psychological support may be necessary due to the emotional impact, which might further contribute to the impression of pain.

If you're suffering from vulvodynia and it's affecting your mental well-being, consulting a psychologist can provide the support and strategies you need.

Diagnosis of Vulvodynia

Since the condition itself doesn't have a specific test, doctors need to rule out other potential causes of vulvar pain before confirming vulvodynia.

Here are some of the steps involved:

Pelvis examination: An examination of your external genitalia and vagina is conducted to detect any signs of infection or other factors contributing to your symptoms. A vaginal cell sample may be collected to test for a yeast or bacterial infection. Your healthcare provider may also perform a manual examination by inserting a gloved finger into your vagina to assess the tenderness of the pelvic floor muscles.

Cotton swab test: A dampened cotton swab is utilized to delicately examine particular regions of discomfort in your vulva. If a sore region is identified, you will probably be questioned about the sensation and intensity of the pain.

Biopsy: If there are any unusual changes in the appearance of the vulva skin, a doctor or gynecologist may take a small tissue sample for laboratory analysis.

Hematological analysis: This may be conducted to assess your hormone levels, including estrogen, progesterone, and testosterone.

Treatment for Vulvodynia

The primary goal of treatment is to relieve the pain in the vulvar area.

A variety of treatments may be prescribed under the supervision of experts, such as:

• Medications to treat vulvar pain may include a cream rubbed on the vulvar area to reduce the pain or nerve pain tablets
• Preliminary pelvic floor exercises to improve vaginal muscle control
• Gently widen the vagina using tampon-shaped objects (by vaginal trainers)
• Psychological therapy, including cognitive behavioural therapy or psychosexual therapy
• Surgery is reserved for specific patients

Self-care measures that can help to manage vulvodynia include:

• Wearing loose-fitting, cotton clothing
• Avoiding irritants, such as soaps, detergents, and fragrances
• Using lubricants during sexual activity
• Applying ice packs or heat packs to the vulva
• Practicing relaxation techniques, such as yoga or meditation

Conclusion

Vulvodynia is a complex and often misunderstood disorder that significantly impacts the lives of affected women. It causes both physical discomfort and mental distress, necessitating appropriate therapies.

By fostering open dialogues, providing support, and advancing research, we can improve diagnosis and treatment, ultimately enhancing the well-being of those affected.

If you or someone you know is struggling with vulvodynia, consult an expert to explore the best treatment options and support available.

FAQs

Is vulvodynia common?

Vulvodynia can impact women of all ages but is more prevalent in young women who experience discomfort during sexual intercourse and may be unable to engage in penetrative sex, known as induced vestibulodynia.

Can vulvodynia affect sexual health?

Yes, vulvodynia can affect sexual health. An open conversation with your healthcare provider and partner is essential for identifying solutions that work for you.

What conditions often happen with vulvodynia?

Women with vulvodynia are frequently diagnosed with other prevalent pain syndromes, such as fibromyalgia, painful bladder syndrome, irritable bowel syndrome, and temporomandibular disorders.

What foods cause vulvodynia?

Consuming processed foods containing caffeine, acid, and high levels of sugar might exacerbate symptoms. Gradually eliminate one item from your diet at a time. Monitor your body's responses. Avoid meals that can increase the irritation of your urine. These may consist of some legumes, fruits, cocoa, and nuts.

References

• Mayo Clinic (2023). Vulvodynia, Symptoms and Causes. Available at https://www.mayoclinic.org/diseases-conditions/vulvodynia/symptoms-causes/syc-20353423 (Accessed 23/02/2024).
  
• WebMD (2023). Vulvodynia. Available at https://www.webmd.com/women/vulvodynia. Accessed 23/02/2024).
• Cleveland Clinic (2022). Vulvodynia. Available at https://my.clevelandclinic.org/health/diseases/17878-vulvodynia. (Accessed 23/02/2024).
• ​Familydocto.org (2023). Vulvodynia. Available at https://familydoctor.org/condition/vulvodynia/ (Accessed 23/02/2024).
• Planned Parenthood (2023). Vulvodynia. Available at https://www.plannedparenthood.org/learn/sex-pleasure-and-sexual-dysfunction/sexual-dysfunction/vulvodynia (Accessed 23/02/2024).
• Healthline (2019). Vulvar Pain: Symptoms, Causes, and More. Available at https://www.healthline.com/health/womens-health/vulvar-pain#TOC_TITLE_HDR_1 (Accessed 23/02/2024).
  
• NHS (2024). Vulvodynia (vulval pain). Available at https://www.nhs.uk/conditions/vulvodynia/#:~:text=Vulvodynia%20is%20pain%20in%20the,are%20treatments%20that%20can%20help. (Accessed 23/02/2024)
• National Library of Medicine (2023). Vulvodynia. Vieira-Baptista P, Lima-Silva J, Pérez-López FR, Preti M, Bornstein J. Vulvodynia: A disease commonly hidden in plain sight. Case Rep Women Health. 2018 Oct;20:e00079. Available at https://www.ncbi.nlm.nih.gov/books/NBK430792/ (Accessed 23/02/2024).