About Vulvodynia
Vulvodynia is a condition involving chronic pain and discomfort of the vulva. The pain recurs and is long lasting. The two most common types of vulvodynia are:

• Generalized — The pain or discomfort can be felt in the entire vulvar area.
• Localized — Pain is felt only in the vestibule (the opening to the vagina).

With both types, the vulva often looks normal even though a woman feels pain. This pain can affect a woman's health and her sex life.

Causes
No one is sure what causes vulvodynia. But it is known that it is not caused by cancer or certain infections, such as human papillomavirus (HPV) or herpes. It is not a sexually transmitted disease. Once your doctor has diagnosed vulvodynia, he or she has ruled out cancer or herpes.

Vulvodynia may be the result of more than one factor.

Symptoms
Women with vulvodynia may have some of these feelings around vulva:

• Burning Stinging Rawness Itching Aching Soreness Throbbing
• Swelling

These symptoms may be constant, or they may come and go. They can begin and end without any warning.

Diagnosis
To diagnose vulvodynia, the doctor will do a physical exam and tests.

The doctor also will examine the vulva and vagina carefully. A sample of discharge from your vagina may be taken and tested for signs of yeast and other infections that could be causing the symptoms.

Treatment
There are many kinds of treatment that may help relieve the symptoms of vulvodynia. No one method works all the time for everyone. Some treatments take a few months before any relief is noticed.

Vulvar Hygiene
Gentle care of the vulva can help provide relief from the pain of vulvodynia:

• Wear 100% cotton underwear (no underwear at night) Avoid tight-fitting undergarments and pantyhose Avoid douching Use mild soaps for bathing and clean the vulva with water only Do not use vaginal wipes or deodorants or bubble bath Do not use pads or tampons with deodorants Use lubrication for intercourse Apply cool gel packs to the vulva area to reduce pain and itching
• Avoid exercises that put pressure directly on the vulva, like bicycling

Medications
Your symptoms may be treated with medications, including:

• Local anesthetics that can provide temporary relief from pain and other symptoms Steroids
• Certain types of antidepressants and anti-convulsants

Other Options
Other things may help you cope with the pain. One of them is to make changes in your diet. Certain foods, like greens, chocolate, berries, beans, and nuts may produce urine that is irritating.

Some women may try physical therapy or biofeedback.

Surgery
For women with severe localized pain who have not found relief through other treatments, surgery may be an option.

Finally ...
Dealing with the chronic pain of vulvodynia can be hard. Finding the cause of the pain can be frustrating. Although there may be no cure for your condition, you may find some relief with treatment. Your doctor will work with you over time to find a method of treatment that works best for you.

This excerpt from ACOG's Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.

Copyright © July 2007 The American College of Obstetricians and Gynecologists