Vulvodynia is a condition that at least 10 to 20% of women
will experience at some point in their lifetime
Vulvodynia involves the nerves of the vulva (the area outside the vaginal opening) becoming sensitised. This commonly results in a sensation of burning, stinging, rawness, generalised pain or soreness in this area. Physiotherapists can provide advice and exercises to help re-train the nerves.
What is vulvodynia?
Vulvodynia is the name given to the condition of persistent vulvar discomfort (lasting 3 – 6 months, but often years) when all other causes for the pain have been ruled out. The pain may have persisted despite adequate management of the original cause (e.g. vaginal thrush). It can significantly impact quality of life for the many women who suffer with the condition, and is often misdiagnosed or inadequately managed.
In vulvodynia, the nerve endings in the vulval skin become extra sensitive (known as ‘peripheral sensitisation’). The neurons in the brain and spinal cord also become sensitive (known as ‘central sensitisation’). This means common, non-painful sensations (such as gentle pressure or stretch, warmth or coolness) can be intensified and are perceived as potentially harmful by the brain. This results in the brain producing a pain response (an ‘output’), which is usually protective and alerts us to danger or harm, such as tissue damage.
However in vulvodynia the brain produces uncomfortable sensations such as pain, burning and stinging in response to non-painful stimuli such as light touch (an ‘input’) at the vulval skin. Often the surrounding muscles (including the pelvic floor muscles) tense up in response to this pain as a protective mechanism. This can make sex painful or impossible, cause difficulty using tampons or having pap smears. It also contributes to a number of other related problems e.g. difficulty emptying your bladder or bowel.
What should you do?
If you are experiencing any of these symptoms and think you may have vulvodynia – it is important to rule out other potential causes of vulvar pain. Potential causes such as infection can be investigated by seeing a medical practitioner (e.g. a GP with a special interest in women’s health). Your GP may refer you to a Gynaecologist for further investigation before you are diagnosed with vulvodynia.
Once you have ruled out other causes of your pain, your Physiotherapist will work with you to determine the most appropriate management plan. This may include stretches, pelvic floor relaxation exercises, along with techniques for vulval desensitisation and general vulval care. This is a topic that will be covered in an upcoming blog post!
A multi-disciplinary approach is needed to effectively manage this condition. This means your Physiotherapist will work closely with other health practitioners, commonly your GP and/or gynaecology or dermatology specialist.
What do I do next?
Do not suffer in silence. If you have been diagnosed or suspect you have vulvodynia, get in touch with one of our experienced Women’s Health Physiotherapist’s. We can provide advice and guide you through assessment and treatment options.
Book online or call us on 1300 189 289.
Women’s Health Physiotherapist and Director of myPhysioSA for her. Payneham, Mount Barker and North Adelaide.