Vulvodynia: Treatment, Cost and Side Effects

Vulvodynia is a condition where chronic pain is felt in the vaginal or vulvar region. The symptoms of burning and itching are mainly associated with the pain and it usually lasts for 3 months. This often leads to discomfort while sitting for a long period of time and during the course of intercourse. The condition usually lasts for months to years without proper diagnosis or treatment. Moreover, the symptoms for vulvodynia is either not visible or sporadic at best that comes and goes.

Due to the nature of the condition, many women find it difficult to talk about vulvodynia or got to a doctor. The condition of vulvodynia might have an adverse impact on a woman’s sexual and physical activities. Moreover, this might start to affect her relationship and lead to low self-esteem. Therefore, it is essential to seek help and treat the condition.

The exact cause of vulvodynia is not known. However, it can be triggered by infections, neurological problems, inflammatory conditions and neoplasms, such as squamous cell carcinoma. Moreover, women are at an increased risk of having vulvodynia if there is damage or irritation of the nerves around the vulva or concentration of pain-sensing nerve fibers are located in the vulva area or high levels of inflammatory substance present in the vulva area or genetic susceptibility or weak pelvic floor muscles or unusual or long-term reaction to infection, trauma or hormonal changes leading to pain. It should be noted that the condition is not contracted due to sexually transmitted disease.

For proper treatment to take place, doctors categories the condition into generalized vulvodynia and localized vulvodynia. In localized vulvodynia, pain is felt in one part of the vulva. If pain is felt in the vestibule, the tissue surrounding the vaginal opening, then it is referred to as vestibulodynia. The majority of women with localized vulvodynia have Provoked vestibulodynia in which pain is felt after and before pressure is applied to the vestibule. It should be noted that a less common form of localized vulvodynia, known as clitorodynia also occurs among women that causes pain in the clitoris. In generalized vulvodynia, chronic pain s felt in different areas of the vulva at different times. The pain may be constant or occur every once in a while.

Diagnosis for the condition may involve regular blood test and a pelvic exam by a gynecologist. A combination of treatment is the best possible cure for the condition which alleviates symptoms and provides moderate pain relief. Medications include steroids, tricyclic antidepressants or anticonvulsants or serotonin-norepinephrine reuptake inhibitors or opioids help in decreasing pain. Medicines like antihistamines help in reducing itching. Doctors may also recommend using topical medications like lidocaine or estrogen creams. You can apply it before having sexual intercourse in which case your partner might feel temporary numbness after sexual contact. You can also use nerve blockers that reduce the pain. Along with oral and topical medications, your doctor might also advise you to practice pelvic floor therapy. These types of exercises help in relaxing the muscles of the pelvic floor. Other treatments include neurostimulation and spinal infusion pump.

However, it should be noted that in rare case when the pain does not subside or the symptoms do not disappear, especially for Provoked Vestibulodynia, doctors might tell you to undergo surgery to remove affected skin and tissue (vestibulectomy), giving you relief from pain.

Some of the symptoms of vulvodynia includes burning, soreness, stinging, rawness, painful intercourse (dyspareunia), throbbing and itching. Women experiencing these symptoms consistently or occasionally are eligible for the treatment. Moreover, if you are feeling pain in your genital area, then you should visit a doctor or gynecologist.

If you have sexually transmitted disease or yeast infections which is causing itching and vaginal odour, then you are not eligible for the treatment of vulvodynia.

As treatments for vulvodynia includes taking anti-depressants and applying topical medications like lidocaine, the side effects caused by both are varied and wide. Side effects from anti-depressants include nausea, increased appetite and weight gain, loss of sexual desires, fatigue and drowsiness, insomnia, dry mouth and constipation. Anticonvulsants side effects include tremor, rash, drowsiness and weight gain.

Side effects of lidocaine include high blood pressure, swelling or redness of the skin or the area applied, tingling sensation to the area applied. However, if you undergo surgery, then side effects may include infection, redness, soreness, pain and bleeding. Side effects of nerve blockers may include numbness and headaches and dizziness.

As the condition of vulvodynia cannot only treated with medications and topical drugs and requires some home remedies and lifestyle changes. Some remedies include which provide relief from pain and itching includes putting cold compresses or gel packs on your genital area, soaking in a bath mixed with Epsom salts or colloidal oatmeal three or four times a day for five to ten minutes. You also try to wash the vaginal area gently using only plain water and dry it after wards. You should do this after urination and intercourse. Moreover, apply a lubricant before having sex to not cause any pain to the area and use dermatological approved detergent to wash your undergarments.

These were the dos. There are numerous things you also should not do including avoid tightfitting pantyhose and nylon underwear because it can restrict airflow to the genital area that will lead to increased temperature and moisture causing irritation. Try to wear white cotton underwear to increase ventilation and keeping it dry. Also, try to avoid hot tubs or soaking in hot baths and also don’t use deodorant tampons or pads because both can cause irritation and itchiness. Avoid activities like horse riding or biking that put pressure on the vulva region.

As the condition is not consistent and reoccurs frequently, recovery will take place once you start taking medications. Within one week of taking medicines you will be relieved of pain and the associated symptoms.

The cost of treating vulvodynia will include doctoral consultation and medicinal charges. Doctor fees usually range from Rs.300 to Rs.1000 and medicinal charges starts from Rs.500 and go up to Rs.2000.

No, the results are not permanent. Even if the condition disappears after taking appropriate medications, it can reoccur after a few months or years.

Besides the usual medications and topical creams, there are a lot of natural remedies that can give you relief from the pain and itching. These include using coconut oil which can be taken orally or applied to the affected vulva region. Other herbs used include oats, peppermint and cayenne pepper. You can use peppermint essential oil mixed with coconut oil and beeswax. Other methods like biofeedback therapy where you exercise your pelvic muscles and control your body movements can also provide relief.