VULVODYNIA
Chronic vulvar pain, often of unknown etiology. The International Society for the Study of Vulvar Disease defines vulvodynia as “vulvar discomfort, most often described as burning pain, occurring in the absence of relevant physical findings or a specific identifiable neurologic disorder.” Sexual function is often disrupted. There are other dermatologic conditions that must often be excluded. Either through the trained eye, or with a small skin biopsy sampling. Vaginal infections may, or may not be, a cofactor or aggravator of symptoms. Treatments are sometimes elusive. Persistence, patients, and personal attention often pay off, and will more often than not yield good results.
There is rarely a magic wand, one treatment option, best suited for all. Basic treatment options include:
Care | • Vulvar care and avoidance of contact irritants are essential. |
| Diet | • Diets such as low oxalate with calcium supplementation may be helpful. |
| Therapy | • Biofeedback, physical therapy, and cognitive behavioral therapy / sexual therapy have been helpful in some. |
| Topical | • Topical Lidocaine, Capsaicin, and Estrogen are often useful in individual cases |
| Oral | • Oral therapies such as Amitriptyline, Norpramin, Neurontin, Paxil, Effexor are often the main stays of therapy in severe persistant cases. |
| Botox | • Local Botox injections are considered experimental., but may be useful. |
| Surgery | • Surgery should be reserved as a last option. |