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Vulvodynia
Vulvodynia refers to a disorder of vulvar pain, burning, and discomfort that interferes with the quality of life. No discernible physical lesion other than perhaps some redness of the vestibule is present. The cause can sometimes be attributed to trauma, but in many other cases its origin is unknown. Additional recommended knowledge
Localized vulvodynia/ vulvar vestibulitisThe condition is one of exclusion and other vulvovaginal problems should be ruled out. Infections, such as Yeast infections and Bacterial vaginosis, and the diseases listed in the differential diagnosis need to be considered. The pain may be generalized or localized in the vulvar region. Localized, vulvodynia in the vestibular region is referred to as vulvar vestibulitis and also vestibulodynia. The pain of vulvodynia may extend into the clitoris; this is referred to as Clitorodynia. It is unclear if these conditions are manifestations of the same disease process as the differential diagnosis is the same and the cause unknown. The pain may be provoked by contact with an object, as is the case with vulvar vestibulitis, or it may be constant. Possible causesA wide variety of possible causes and treatments for vulvodynia are currently being explored. Some possible causes include: allergy or other sensitivity to chemicals or organisms normally found in the environment, autoimmune disorder similar to lupus erythematosus, chronic tension or spasm of the muscles of the vulvar area, infection, injury, chemical sensitivity and neuropathy. Some cases seem to be negative outcomes of genital surgery, such as a labiectomy. Dr. John Willems, head, division of obstetrics and gynecology, Scripps Clinic believes that vulvodynia is a subset of fibromyalgia. Vulvodynia is also frequently found in patients suffering from interstitial cystitis. DiagnosisThe diagnosis is based on the typical complaints of the patient, essentially normal physical findings, and the absence of identifiable causes per the differential diagnosis.
A cotton “swab test” is used to delineate the areas of pain and categorize their severity. Patients often will describe the touch of a cotton ball as extremely painful, like the scraping of a knife. Differential diagnosis
TreatmentThere is no uniform treatment approach and numerous proposed treatments are based primarily on empirical experience and opinion. Treatment is often very different from physician to physician and many patients will have to change their course of treatment when primary attempts fail. Treatments include:
The guidelines in Vulvovaginal health may be of some help.
Vulvodynia in the mediaIn Season 4, Episode 2 "The Real Me" of Sex and the City, Charlotte is diagnosed with Vulvodynia and prescribed antidepressants. This episode was received with much criticism, notably from the National Vulvodynia Association, which objected to the portrayal of the condition as a fleeting, minor condition. Season 1, Episode 3 ("In Which Addison Finds the Magic") of Private Practice includes a couple seeking treatment for vulvar vestibulitis and Vaginismus. Again, the topic was treated with ignorance about the severe and debilitating nature of the two conditions and made so many mistakes regarding the treatment of them both as to render the episode devoid of anything accurate or informative. Susanna Kaysen, well-known for her novel, Girl, Interrupted, and its film adaptation, has also published The Camera My Mother Gave Me, a novel concerning her own experience with vulvodynia and its debilitating symptoms. ReferencesACOG Committee on Gynecologic Practice (2006). "ACOG Committee Opinion Number 345: Vulvodynia". Obstet Gynecol 108 (4): 1049–1052. PMID 17012483 Stewart, Elizabeth; Paula Spencer (2002). The V Book: A Doctor's Guide to Complete Vulvovaginal Health. Bantam Trade Paperback, pp. 297-328. ISBN 0-553-38114-8. Goldstein, Andrew T.; Marinoff, Stanley C. & Christopher, Kurt et al. (2006), " ", The Journal Of Sexual Medicine 3 (5): 923-931 PMID 17012483 Goldstein, Andrew (2005), , What Your Doctor May Not Tell You About Fibromyalgia, by R. Paul St. Amand, MD and Claudia Craig Marek, Warner Wellness, 2006. Vulvodynia-Treatment Kits include soothing Calendula Creme: http://www.Vulvodynia-Treatment.com See alsoCategories: Pain | Gynecology |
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This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Vulvodynia". A list of authors is available in Wikipedia. |