Vulvodynia

From Anvita Health Wiki

Contents 1 Introduction 2 Classification 3 Etiology 4 Epidemiology 5 Complications 6 Management 7 More General Terms 8 Additional Terms 9 References

Introduction

• Pain of the external female genital organs including vulva, labia, clitoris, & vaginal opening

Classification

• generalized vulvodynia
• vulvar vestibulitis syndrome (pain in the vestibule)

Etiology

• idiopathic [3]
• no evidence of infectious etiology (i.e. sexually transmitted disease)
• postulated causes include:

• nerve injury or irritation
• genetic factors
• hypersensitivity
• muscle spasms
• hormonal changes
• history of sexual abuse
• chronic urinary tract infection ? [3]
• Candida vulvovaginosis

Epidemiology

• 4% of women Clinical manifestions:
• chronic vulvar pain
• symptoms usually begin suddenly
• duration months to years
• burning, stinging, or rawness
• ching, soreness, or throbbing
• itching
• symptoms may be intermittant or constant
• symptoms may be exacerbated by activities such as exercise or may occur while at rest
• symptoms may occur in a specific area or throughout the entire vulva
• diminished quality of life
• dyspareunia 90%
• age at onset: 60% age > 30 years; 20% age < 20 years
• vulva generally appears normal, but may appear inflamed or swollen
• fibromyalgia 3-fold more common than in general population
• irritable bowel syndrome 3-fold more common than in general population

Complications

• increased referral to specialists
• physical & emotional stress

Management

• no standard satisfactory treatment [3]
• treat urinary tract infection
• treat vulvovaginitis
• topical gabapentin 2,4 or 6% compounded by pharmacist may be of benefit [3]
• avoid potential irritants [4]

• certain soaps, scented materials, douches, perfumes
• hot tubs or pools with lots of chlorine

• rinse the vulva with cool water after urination & intercourse
• avoid foods that make urine more irritating

• greens, beans, berries, chocolate, or nuts

• wear loose-fitting pants & skirts; don't wear pantyhose [4]
• keep the vulva clean & dry
• use a water-soluble lubricant during sex
• avoid activities that put direct pressure on the vulva

• bicycling & horseback riding

• sit on a foam rubber doughnut
• lukewarm or cool sitz baths [4]
• therapy or a support group

More General Terms

• pain [odyn-]

Additional Terms

• vulva

References

1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 398-99
2. Arnold LD, Bachmann GA, Rosen R, Kelly S, Rhoads GG. Vulvodynia: Characteristics and Associations With Comorbidities and Quality of Life. Obstet Gynecol. 2006 Mar;107(3):617-624. PMID: [1]
3. Boardman LA et al. Topical gabapentin in the treatment of localized and generalized vulvodynia. Obstet Gynecol 2008 Sep; 112:579. PMID: [2]
4. WebMD: Vulvodynia: Causes, Symptoms, and Treatments [3]
5. Mayo Clinic: vulvodynia [4]
6. National Guideline Clearinghouse The vulvodynia guideline. American Society for Colposcopy and Cervical Pathology ngc-guideline: [5]

vulvodynia