Clinical Management of Vulvodynia
Vulvodynia, also known as burning vulva syndrome, is characterised by sensory abnormalities of the vulva and the surrounding tissue, such as an unpleasant burning and itching sensation, or a painful response to a stimulus that is not usually painful such as sexual intercourse or the touch of a cotton swab.
This article appears in Reviews in Gynaecologial Practice, September 2002, Volume 2, Issues1-2, Elsevier Press.
Abstract
Vulvodynia, also known as burning vulva syndrome, is characterised by sensory abnormalities of the vulva and the surrounding tissue, such as an unpleasant burning and itching sensation, or a painful response to a stimulus that is not usually painful such as sexual intercourse or the touch of a cotton swab. Organic vulvodynia is often treatable once a cause has been established. Idiopathic vulvodynia, which consists of vulvar dysesthesia or vestibulodynia vulvar vestibulitis syndrome, often exists in conjunction with organic vulvodynia. Both entities should be treated concurrently, if possible. Several treatment methods exist for idiopathic vulvodynia and most may be used in conjunction with each other. Treatment options that are less invasive are often tried first, including hygienic and dietary changes, surface electromyographic biofeedback, and medications. Surgery, effective only for vestibulodynia vulvar vestibulitis syndrome and usually considered only for women refractory to other treatments, can be combined with other treatments (interferon, and sEMG biofeedback for example) to increase effectiveness. A pathway of treatment options is presented.
Introduction
Vulvodynia, also known as burning vulva syndrome, is characterised by sensory abnormalities of the vulva and the surrounding tissue, such as an unpleasant burning and itching sensation, or a painful response to a stimulus that is not usually painful such as sexual intercourse or the touch of a cotton swab. The onset of vulvar pain may be associated with episodes of yeast infection, infection by genital herpes virus, trauma such as childbirth, or certain therapeutic procedures on the vulva, including cryosurgery including cryosurgery or laser surgery, or may occur spontaneously (Paavonen, 1995).1 The intensity of this chronic pain, usually lasting more than three months, can range from mildly irritating to totally debilitating. It can be cyclic in nature, with some periods of abatement followed by periods of greater intensity.
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