Conventional Treatments for Vulvodynia

What is Vulvodynia?

Vulvodynia is a chronic pain condition affecting the vulva (vaginal opening); it presents as pain in the labia, clitoris and/or vaginal opening. A diagnosis of vulvodynia requires that the pain is present for at least three months. Vulvodynia has no identifiable cause and is a diagnosis of exclusion. Although the cause is still unknown, research is ongoing.

Conventional treatment options for vulvodynia

Treatment plans are highly individualized and focus on relieving the symptoms of vulvodynia. A health care professional may suggest a combination of treatments for best results, including the following:

• Medications, such as steroids, anticonvulsants or tricyclic antidepressants, can reduce the symptoms of nerve pain and/or swelling associated with vulvodynia.
• Local anesthetics, such as lidocaine ointment, can reduce vulvodynia-related itching. Lidocaine ointment applied 30 minutes prior to sexual intercourse may ease discomfort; however, a sexual partner may experience numbness following contact.
• Transcutaneous electrical nerve stimulation (TENS) is a relatively new treatment for vulvodynia that can reduce pain.
• Biofeedback therapy involves teaching individuals how to relax the vaginal muscles to help control how the body responds to vulvodynia symptoms.
• Physical therapy can help control pelvic floor muscle spasms. Pelvic floor therapy helps relax pelvic floor muscles, resulting in reduced pain.
• Nerve blocks may be used when a woman does not respond to other treatment options. Nerve blocks involve injecting medication into the affected nerves, which interrupts pain signals sent to the brain.
• Vestibulectomy is a relatively safe and effective surgery that can be used as a final treatment option for vulvodynia if other treatment options fail. Occasionally, vestibulodynia (an excessive sensitivity of nerve fibers or an overgrowth of nerve fibers in the genital area) occurs with vulvodynia. Vestibulectomy surgery involves the removal of the affected tissue to reduce pain levels. General anesthesia is used during vestibulectomy surgery. A referral to a gynecologist or specialist should be obtained when considering surgery.