Vulvodynia, or discomfort in the vulva without a known cause, can occur spontaneously or in response to contact in both sexual and non-sexual contexts. The word dyspareunia refers to pain that occurs solely during intercourse and can involve vulvodynia (pain that is limited to the vulvar area) or deeper discomfort. There are many vulvodynia treatment available to provide symptom relief.
Vulvodynia is a disorder that affects 8-10% of women of all ages and is defined by discomfort in the vulva during sexual and/or non-sexual situations. It reduces the quality of life for women and their spouses and imposes a significant personal and community economic burden. Furthermore, women with vulvodynia are more prone to report other chronic pain disorders, which reduces their quality of life even further.
Symptoms of vulvodynia
A painful, raw, burning, or stinging feeling is the most typical symptom. Some women describe the agony as ‘knife-like’ or as though acid was spilled on their skin. Pain might be persistent, intermittent, or only occur with pressure or touch. Other possible symptoms include throbbing, itching, or rawness. The majority of sexually active women claim that intercourse is painful or difficult.
Women, on the other hand, describe the discomfort as stinging, ripping, stabbing, or itching. Pain with pressure or contact with the vestibule is another symptom.
- having intercourse
- using a tampon
- getting a pelvic exam,
- sitting for long periods
- wearing tight trousers
- when exercising (such as biking or walking)
- intermittent pain
- only experiencing discomfort in the vestibule or bottom part of the vagina
- some women experience discomfort when urinating
- Your vulva may seem a little enlarged or irritated, but for the most part, it looks normal.
Using Syren Gel to relieve vulvodynia
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Benefits of Syren
- Syren intimate relief gel is the natural choice for vulvodynia sufferers.
- Syren is 100% pure, certified organic, and free of potentially dangerous chemicals or known skin irritants.
- Syren Intimate Relief Gel Topical works by reducing pain perception by stopping the transmission of pain impulses from peripheral nerves in and around the vulva.
- Intimate Relief also hydrates the vulva and enhances blood flow to it.
- Syren Intimate Comfort A topical vulvodynia treatment, is a pain relief gel designed to treat vulva pain.
When should I see a doctor about vulvodynia?
Some women are hesitant to bring up the subject. If you experience persistent pain in the vulva area, consult your gynecologist or primary care physician. You should call again if the situation worsens.
How is vulvodynia diagnosed?
There is no particular test that can detect if you have vulvodynia. Other factors must be ruled out throughout the diagnosis process.
Your doctor will inquire about your medical, sexual, and surgical history, as well as the nature of your problems. A pelvic examination may also be performed by your doctor to rule out infection or other reasons for your symptoms. They may also collect cells from your vagina or vulva to test for bacterial or yeast infections. Your doctor may also examine your pelvic floor muscles to ensure they are not tight, constricted, or unpleasant to the touch.
A cotton swab test (Q tip test) may also be performed as part of the examination, in which the doctor applies light pressure to various locations of your vulva to check for localized discomfort.
The doctor will apply light pressure to several locations of your vulva and ask you to assess your discomfort level throughout this exam. This will aid in the identification of particular locations of discomfort.
Vulvodynia is diagnosed when all other reasons have been ruled out.
Lifestyle and home remedies
The following suggestions may assist you in managing vulvodynia symptoms:
- Use cold compresses or gel packs to relieve pain. To relieve discomfort and irritation, apply them immediately to your external genital region.
- Take a sitz bath. Sit in comfortable, lukewarm (not hot) or cold water with Epsom salts or colloidal oatmeal for five to ten minutes two to three times a day.
- Avoid wearing tight-fitting pantyhose or nylon underwear. Tight clothing inhibits airflow to your genital area, which can cause discomfort due to increased warmth and dampness.
- To enhance ventilation and dryness, use white cotton underwear. Try sleeping without your underpants on one night.
- Avoid using hot tubs and taking hot baths. Spending time in hot water might cause pain and itchiness.
- Use no deodorant tampons or pads. The deodorant may be irritating. If the pads irritate you, switch to 100% cotton pads.
- Activities that create pressure on your vulvae, such as biking or horseback riding, should be avoided.
- Wash with care. Scrubbing the afflicted region hard or washing it too frequently might aggravate the discomfort. Instead, gently clean your vulva with simple water and wipe the region dry.
- After bathing, establish a protective barrier with a preservative-free emollient, such as basic petroleum jelly.
- Make use of lubricants. Apply lubrication before having sex if you’re sexually active. Avoid using items containing alcohol, flavoring, or warming or cooling ingredients.
Coping and support
Talking to other women who have vulvodynia may be beneficial since it may give you the knowledge and make you feel less alone. If you don’t want to attend a support group, your doctor may be able to refer you to a counselor in your region who has expertise in assisting women with vulvodynia.
Sex therapy or couples therapy may help you and your spouse cope with the effects of vulvodynia on your relationship.
Risks and complications
Vulvodynia can have a significant influence on your life and hinder you from partaking in typical daily activities. It may either make you desirous of sex or make you frightened of sex. Fear of sex can also induce spasms in the muscles around your vagina (vaginismus). Other side effects of vulvodynia include:
- problems in relationships
- issues with sleep
- improper sexual behavior
- undesirable body image
- a lower standard of living
There are vulvodynia treatments available to alleviate symptoms. These may include vulvar skin care guidance, oral and/or topical drugs, physical therapy and biofeedback training, dietary changes, psychotherapy, and, in rare situations, surgery. Acupuncture, massage treatment, and cognitive behavioral therapy are also being investigated as adjunct therapies.
Vulvodynia has no recognized treatment. Treatment’s major aims are to control your pain, enhance your quality of life (for example, restoring a healthy sex life and reducing stress) and prevent the recurrence of symptoms
Due to the chronic nature and complexities of vulvodynia, various vulvodynia treatment methods are usually necessary. Finding the best therapy or mix of therapies may take some time, especially because each woman’s symptoms and response to treatment are different. Your doctor will propose a treatment plan depending on your condition(s), amount of discomfort, and personal preferences.
Available Treatment Options
The following section (in no particular sequence) presents an overview of available therapies that have been useful in lowering pain symptoms:
Basic vulvar care.
These tips will benefit all women, not just those suffering from vulvar discomfort. Some frequent vulvar care recommendations include:
- only using cotton underwear
- avoiding skin-tight pants and pantyhose
- use odorless cotton pads and tampons
- avoiding the use of strong soaps and shampoos in the vulva region and refraining from using douches
- use a lot of water-soluble lubricant during sexual intercourse
- after washing and urinating, patting the area dry
Chronic pain may be treated with oral and/or topical drugs, such as topical anesthetics (lidocaine ointment), estrogen, anticonvulsants, and some antidepressants.
Topical anesthetic ointments give immediate, brief pain relief and comfort and can be used overnight or 15 to 20 minutes before sexual activity or as needed during the day. Ice packs also provide temporary comfort and may be effective when you are unable to avoid sitting for extended periods, such as during lengthy car rides.
Topical estrogens, and occasionally testosterone, may be used in estrogen-deficient women, such as postmenopausal women or premenopausal women on estrogen-lowering medicines.
Low doses of tricyclic antidepressants, particularly amitriptyline (Elavil), desipramine (Norpramin), and nortriptyline, may be given to treat vulvodynia due to their pain-blocking properties (Pamelor).
Gabapentin, an anti-seizure medicine, is useful for pain management in some women and provides an option for women who are unable or have negative effects from tricyclic antidepressants.
Inquire with your doctor about various drugs and their frequent adverse effects. When using some medications, keep in mind that symptoms may not completely go away and may take up to six or eight weeks to get better.
Physical therapy and biofeedback training.
Some women have spasms or weakening of the pelvic floor muscles, which may contribute to or develop as a result of the vulvar discomfort. Your doctor will check the muscles in your pelvic floor and might suggest that you see a pelvic floor physical therapist to have the muscles, joints, and nerves in the pelvic area thoroughly examined.
Treatments may include:
- manual therapies, such as massage.
- hot/cold packs
- electrical stimulation may also provide some relief.
Physical treatment includes biofeedback, which teaches you how to manage the contraction and relaxation of your pelvic muscles and assists you in achieving a calm condition to lessen discomfort.
By enabling deliberate relaxation of these muscles to take place, learned control of these muscles can help in circumstances when discomfort may arise, such as during sexual activity or a pelvic exam.
Relaxation and breathing techniques.
Similar to biofeedback, learning particular relaxation techniques to lower tension and anxiety and then becoming aware of when you are tensing your pelvic floor muscles as a result of stress might assist relieve discomfort.
Discuss the advantages and disadvantages of cutting out particular food categories from your diets, such as those rich in oxalates or sugar, with your healthcare physician. Eliminate one item or food category at a time to test for food sensitivity and establish which foods, if any, are having an impact on you. Keep track of your findings in a food diary; you could start to see a connection between your symptoms and certain meals that you wouldn’t have otherwise realized. In particular, this could be beneficial for females who also suffer interstitial cystitis.
Injections of lidocaine or lidocaine combined with a steroid may offer at least temporary and, in some cases, long-term relief from vulvar discomfort. Local injections into trigger points or particularly painful locations at the entrance or a short distance in the vagina may be used, or the bigger, pudendal nerve, which transmits most of the nerves from the vulvar area to the spinal cord, may be used.
Neurostimulation and spinal infusion pump.
If previous treatment options haven’t worked and your pain is severe, your doctor may refer you to a specialist in neurostimulation or the use of a spinal infusion pump. An electronic device administers low-voltage electrical stimulation to a particular nerve or the spinal cord to replace pain with a tingling sensation.
A spinal infusion pump is an implanted device that delivers a modest dosage of medicine to the spinal cord and nerve roots continuously to assist dull pain. There has been little experience using these therapies to treat vulvodynia.
Women who have severe vulvodynia in the vestibule and have not found relief from conventional treatments may consider vestibulectomy, a surgical technique that eliminates the painful vulvar vestibule tissue. This operation is often reserved for women with vulvar vestibulitis who have not responded to more conservative treatments and are aware that, despite the surgery, the discomfort may not disappear.
Vulvodynia can limit everyday activities, disrupt interpersonal and intimate relationships, and reduce the overall quality of life. Women who endure persistent vulvar discomfort may also experience sadness and low self-esteem. Whatever treatments are used to alleviate vulvar discomfort, psychological counseling can assist women in developing coping mechanisms and dealing with sexual intimacy concerns. It is an important aspect of many people’s overall treatment strategies. Individual, marital, or sex therapists, as well as cognitive-behavioral therapists, may be explored. Consult with your doctor about which therapies are best for you.