Read more about this disease, some with Classification – Types – Signs and symptoms – Genetics – Pathophysiology – Diagnosis – Screening – Prevention – Treatment and management – Cures and much more, some including pictures and video when available.
Vulvodynia refers to a disorder of vulvar pain, burning, and discomfort that interferes with the quality of life. No discernible physical lesion other than perhaps some redness of the vestibule is present. The cause can sometimes be attributed to trauma, but in many other cases its origin is unknown.
The condition is one of exclusion and other vulvovaginal problems should be ruled out. Infections, such as yeast infections and bacterial vaginosis, and the diseases listed in the differential diagnosis need to be considered. The pain may be generalized or localized in the vulvar region. Localized, vulvodynia in the vestibular region is referred to as “vulvar vestibulitis” and also “vestibulodynia”. The pain of vulvodynia may extend into the clitoris; this is referred to as “clitorodynia”. It is unclear if these conditions are manifestations of the same disease process as the differential diagnosis is the same and the cause unknown. The pain may be provoked by contact with an object, as is the case with vulvar vestibulitis, or it may be constant.
A wide variety of possible causes and treatments for vulvodynia are currently being explored. Some possible causes include: allergy or other sensitivity to chemicals or organisms normally found in the environment, autoimmune disorder similar to lupus erythematosus, chronic tension or spasm of the muscles of the vulvar area, infection, injury, chemical sensitivity and neuropathy. Some cases seem to be negative outcomes of genital surgery, such as a labiectomy.
Dr. John Willems, head, division of obstetrics and gynecology, Scripps Clinic believes that vulvodynia is a subset of fibromyalgia. Vulvodynia is also frequently found in patients suffering from interstitial cystitis. Recent (2006/2007) literature also suggests this may be a symptom of late onset (3 months to 2 years post transplant) chronic graft vs host disease (cGVHD) for bone marrow and peripheral stem cell transplant patients.
The diagnosis is based on the typical complaints of the patient, essentially normal physical findings, and the absence of identifiable causes per the differential diagnosis. A cotton “swab test” is used to delineate the areas of pain and categorize their severity. Patients often will describe the touch of a cotton ball as extremely painful, like the scraping of a knife.
Many sufferers will see several doctors before a correct diagnosis is made. Many gynecologists are not familiar with this family of conditions, but awareness has spread with time. Sufferers are also often hesitant to seek treatment for chronic vulvar pain, especially since many women begin experiencing symptoms around the same time they become sexually active. Moreover, the absence of any visible symptoms means that before being successfully diagnosed many patients are told that the pain is “in their head”.
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