Vulvodynia or Vulvar Vestibulitis Syndrome only affects women and refers to a condition of chronic vulval pain where no medical cause can be found. Diagnosis therefore involves excluding other possible causes for the symptoms. Patients may experience pain, burning, itching, ‘rawness’ or tenderness and pain with intercourse. Patients may also describe swelling sensation, stabbing or shooting pains or pain in the clitoris, (clitorodynia). Other possible causes to be excluded include, yeast or other infections, sexually transmitted diseases, and various dermatitis conditions. The pain patients experience is real. This is not a psychological condition.
The cause is unknown and there may some type of hypersensitivity or ‘allergic’ reaction. There may be genetic risk factors. It is not contagious.
The examination findings include swelling, dryness, redness or red spots, tenderness or in many women examination is entirely normal.
Because many women experience pain with intercourse they can develop a fear or having sex and secondary psychological problems affecting their relationships.
Most women can be helped. Treatment involves behavioural measures such as avoiding tight or irritating clothing, using low irritant soaps etc, low irritant lubrication products and diet. Some women’s symptoms are improved by diets low in yeast and refined carbohydrates. Other therapy includes biofeedback and counselling from someone experienced in treating this condition. Topical treatments including steroids and lignocaine and oral medications such as amitriptyline and gabapentin can also help some women.
