Overview

Vulvodynia is defined as vaginal pain or discomfort and is usually described as a burning pain occurring in the absence of a specific disorder. Vulvodynia may be 'generalized' involving the entire vulva, or 'localized' involving a portion of the vulva, e.g. clitoris, vestibule etc.

Symptoms

The main symptom is that of vaginal pain. This pain can be described as burning or sharp in nature with dull overtones.  It may be provoked, i.e. by sexual and/or nonsexual contact, or unprovoked, i.e. spontaneous or mixed (provoked or unprovoked).

Diagnosis

Diagnosis is determined following a thorough history and physical examination. Examination should determine if there are treatable causes of the vulvodynia. Occasionally investigations may be needed to exclude treatable causes.

Causes

  • Vulvar Vestibulitis
  • Chronic vulvovaginitis
  • Allergic Dermatitis

Treatment

Treatment depends on the cause of the vulvodynia and may include:

  • Antifungals
  • Antihistamines/Corticosteroids
  • Oestrogens
  • Tricyclic Antidepressants
  • Anticonvulsants
  • Local Anaesthetics
  • Botox
  • Pelvic floor physiotherapy

In severe cases or when the above mentioned treatments fail, surgery or neuromodulation involving stimulator leads may be necessary.