Vulvodynia symptoms include pain in your vulva, or the area around your vagina. The pain may be constant or occasional. Your pain might be in the whole vulvar area (generalized), or it might be localized to a specific area, like your clitoris or entrance to the vagina (vestibule).
It is not possible to know what causes vulvodynia, but there are many risk factors that can make it worse. Some of these include anxiety, depression, post-traumatic stress disorder, fibromyalgia, irritable bowel syndrome, or chronic pelvic pain.
Your doctor will ask about your symptoms, including the location and provocation of the pain. Your doctor will also want to know your medical history and whether you are currently taking any medication that could be causing the symptoms.
The doctor will then perform a physical examination and a pelvic exam. Your doctor will also use a cotton swab to determine the exact areas of your pain.
If you have a positive cotton swab test, then your doctor will do a biopsy of the area that is causing the pain. This will help identify the cause of your symptoms and can be helpful in deciding on treatment.
Treatment: The doctor will prescribe a variety of medications that will reduce the pain, including topical creams and ointments that contain anesthetics or nerve-stabilizing medications. Your provider might also recommend antidepressants and anticonvulsants that can be taken by mouth.
Some women find a mixture of different medications can bring them the most relief. You might also try a combination of acupuncture, massage therapy, biofeedback and cognitive behavioral therapy (CBT).
You can apply an anesthetic gel to your vulva to ease pain before sex. Lidocaine is the most common anesthetic, but numbing creams can be used too. You should wipe it off before sex and ask your partner to wear a condom when using it to prevent it from being damaged by the anesthetic.
There is no cure for vulvodynia, but you can manage your symptoms to improve your quality of life. You should work closely with your doctor to develop a treatment plan that is tailored to your needs.
The goal is to relieve your pain and keep you comfortable and active in everyday activities. This can take time, but it is possible to get relief.
At home: Managing your symptoms at home involves avoiding activities that put pressure on the vulva, like cycling or horseback riding. You should also avoid irritants such as deodorants, bubble baths, and tight-fitting clothing. You should also use unscented toilet paper and tampons, and switch to 100 percent cotton pads.
Soaking your vulva in water with Epsom salts or oatmeal several times a day helps to hydrate and soothe the tissue. You should also take a daily shower, as this can help to cool the area down and reduce itching.
Your GP may refer you to a specialist vulvodynia clinic if your pain is severe or persists. You might see a pelvic pain gynecologist, a neurologist, a dermatologist or a physical therapist.
