Vulvodynia is a persistent pain that affects a woman’s vulva, and in some cases the perineum. The symptoms range from irritation all the way to stabbing pain. This chronic condition can be brought on by traumas such as pregnancy and post surgical scarring, activities like cycling and horseback riding — even snug clothing can heighten existing symptoms.
Vulvodynia is often a diagnosis of exclusion, as it shares many of the same symptoms with conditions such as fungal, bacterial and viral infections; skin cancer; inflammatory skin conditions; allergic reactions; and certain neurological disorders.
Very often, vulvodynia patients show evidence of musculo-skeletal abnormalities of the pelvic floor due to sacroiliac and lumbo-sacral joint dysfunction. Once these musculo-skeletal issues are resolved, patients frequently report that their vulvodynia symptoms either diminish or disappear.
The Women’s Health Institute estimates that as many as 14 million women are affected by vulvodynia sometime during their lives. Hispanic women are 80 percent more likely to experience vulvodynia (23%), while chronic vulvar pain occurs equally among white and African America women (16%). Asian American women were the least likely to be diagnosed with vulvodynia (11%).
In addition to being a challenging disease to diagnose, vulvodynia is challenging to treat as well. Our 60 years of collective medical experience has taught us that an individualized, integrated, multidisciplinary approach to treatment is the most successful.
In order to create such a treatment plan, we must move beyond symptoms to discover the causes beneath them. (Why is your vulva in chronic pain? What can we do to make this pain go away permanently?) The answers to these questions allow us to treat the whole person — which is always the best approach.
1. Drink 8-10 glasses of pure water every day.
2. Low Oxalate Diet
3. Take showers instead of baths
4. Avoid urinary tract irritants (don’t eat anything you wouldn’t put on an open wound)
- Spicy foods (peppers, curry, wasabi)
- Acidic foods (citrus, tomatoes, apples, pineapple)
- Carbonated beverages (sodas, energy drinks)
- Caffeine (coffee, tea, even chocolate)
6. Herbal/Homeopathic remedies
7. Wipe from front-to-back after urination and bowl movements
8. Use birth control that doesn’t irritate your urinary tract (i.e. diaphragms, spermicides, and condoms, if possible)
9. Avoid douches and perfumes near the genitals
10. Empty you bladder before and after intercourse
Diagnostic Tools for Vulvodynia
- Medical history
- Physical exam
- Cultures for bacterial and yeast infections
- Blood tests for hormones
- Allergy testing
- Spinal/pelvic MRI
- Pelvic ultrasound
Vulvodynia Treatment Options
- Pelvic floor exercises
- Sacroiliac alignment
- Myofacial release
- Frequency specific Microcurrent
- Biofeedback/Electrical stimulation
- Allergy testing
- Medications (oral, vaginal, topical, and injections)
- Pudendal nerve entrapment/Pudendal neuralgia