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The Female Body
|What Is Vulva Pain?
Pain or discomfort in the vulvar area that lasts more than 3 months may be diagnosed as vulvodynia. Vulvodynia is characterized by pain which ranges from mild to severe. It is usually present during or after intercourse and other factors may exacerbate it such as inserting a tampon or riding a bike. In some women the pain comes out of the blue while in others it is persistently in the background. The cause of vulvodynia has not been identified but examination of tissue from the affected area under a microscope usually reveals chronic inflammation without evidence of allergy. For years vulvodynia was dismissed as a 'being in the head' condition because there is no obvious physical cause or cure. Some women spent years going from doctor to doctor looking for a diagnosis of their nameless disease. Many were diagnosed incorrectly with other vulva disorders and underwent painful and unnecessary laser or electrocautery surgery. And others were dismissed as being 'frigid' and accused of not embracing their womanhood. It was only in 1983 that recognition of vulva pain and the effects it has on the lives of women all over the world led to the adoption of the term “vulvodynia” by the International Society for the Study of Vulvovaginal Diseases (ISSVD). Even today however, some doctors work on the assumption that vulvodynia symptoms are rooted in the emotions, despite growing evidence that it is physical (although the cause has not yet been identified).
It is estimated that up to 200,000 American women suffer from vulvodynia, often to point where their family and work life suffer. The symptoms include:
Vulvodynia is a complex condition, the cause of which has not yet been identified. It may stem for a number of different physical causes such as:
A diagnosis of vulvodynia can only be made after ruling out other possible causes, including:
How Doctors Differentiate A Diagnosis
In some instances vulva pain disappears on its own without treatment. Other women adapt by finding sexual positions that make painful intercourse less likely. Women who do seek treatment may be prescribed medications. Even if they have no signs of depression, low doses of antidepressants such as Elavil can help alleviate what is known as 'neuropathic' pain. If pain is linked to high levels of calcium oxalate, medications such as calcium citrate can help to reduce levels and relieve symptoms. If pain is localized in one specific part of the vulva (known as vulva vestibulitis), surgical excision of the area may be recommended (procedure is called vestibulectomy or perineoplasty). For more see, treatment of vulvodynia.
Doctors still do not understand the natural progression of vulvodynia. Many women have it for years and it is considered chronic (ongoing). Yet, recent research shows that nearly 50 percent of women who were once diagnosed with the condition, no longer have it. Hence it is thought that in many instances, it eventually clears on it’s own. The prognosis for those who receive treatment is very good. One study at the University of Michigan suggested that those who received treatment had a very good recovery rate.
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