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What is Vulvar Pain
Vulvar pain is long-lasting (chronic) pain in the external female genitalia (vulva). This condition may also be called vulvodynia. The vulva includes tissues surrounding the vaginal opening and the urethra. Vulvar pain often has no known cause.
There are two main types of vulvar pain:
- Localized vulvar pain. This is pain that affects a specific area
of the vulva.
- Vulvar vestibulitis syndrome (VVS) is a type of localized vulvar pain in which pain is only felt around the opening (vestibule) of the vagina.
- Generalized vulvar pain. This is pain that affects:
- The entire vulva.
- Multiple areas of the vulva.
- One side of the vulva.
What are the causes of Vulvar Pain?
The cause of this condition is often not known. Many factors may contribute to it. Vulvar pain may be a type of nerve pain (neuropathic pain).
What increases the risk?
You are more likely to develop this condition if you have:
- Pelvic floor dysfunction. This is a problem in the muscles of your pelvis. These muscles support the bladder, uterus, rectum, and prostate.
- A disorder that affects a protein (interleukin 1 beta receptor antagonist) that is involved in inflammation in the body.
- An increased number of pain receptor nerves throughout the body.
- Painful bladder.
- Irritable bowel syndrome (IBS).
- Fibromyalgia. This is a condition that causes chronic pain in many parts of the body.
- Restless sleep.
- Depression.
What are the signs or symptoms?
The main symptom of this condition is pain that affects part of the vulva or the entire vulva. Pain may:
- Feel like a burning, tearing, stinging, or sharp, knife-like sensation.
- Be chronic and ongoing.
- Come and go (be intermittent).
- Get worse when touching or putting pressure on the vulva, such as when inserting a tampon, engaging in sexual intercourse, sitting for a long time, or wearing tight pants.
Symptoms may also include:
- Swelling or redness of the vulva, perineum, or inner thighs.
- Psychological or emotional distress.
How is this diagnosed?
This condition may be diagnosed based on:
- Your symptoms and your medical history. Your health care provider may ask questions about what causes or worsens your pain.
- A physical exam of your abdomen and pelvis. This may include a cotton swab test, in which your health care provider gently touches all areas of your vulva with a cotton swab to determine where you have pain.
- Tests of your vaginal fluid. These tests may be done to check for infection.
How is this treated?
Treatment for this condition depends on the cause and severity of your pain. Treatment may include:
- Caring for your skin in the vulvar area.
- Working with a health care provider who specializes in pain.
- Physical therapy. This may include doing pelvic floor exercises.
- Counseling (psychotherapy). This may include:
- Biofeedback. This is a type of therapy that helps you be more aware of your body’s response to pain. It also helps you learn to deal with pain.
- Complementary medical therapies to help relieve pain, such as:
- Hypnotherapy. This means being put in a state of altered consciousness (hypnosis).
- Acupuncture. This is the insertion of needles into certain places on the skin.
- Surgery to remove affected parts of your vulva.
Follow these instructions at home:
Clothing
- Wear cotton underwear.
- Avoid wearing tight pants or pantyhose.
- Wash clothing in non-scented, mild laundry detergent. Do not use fabric softeners or dryer sheets.
Eating and drinking
- Avoid caffeine.
- Avoid foods that are highly processed or high in sugar.
Self care
- If any soaps, lotions, creams, or ointments cause or worsen your pain, do not use these products on the affected areas.
- Do not use feminine wipes or douches.
- Do not use scented body soaps, scented pads, or scented tampons.
- Do not use hot tubs or take hot baths.
- Clean your vulvar skin with warm water only and pat the area dry.
General instructions
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Consider using a non-scented silicone-based or oil-based lubricant during sexual intercourse.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- Your pain gets worse or does not improve after starting treatment.
- You develop vaginal discharge that smells bad.
Summary
- Vulvar pain is long-lasting (chronic) pain in the external female genitalia (vulva). This condition may also be called vulvodynia. The vulva includes tissues surrounding the vaginal opening and the urethra.
- Symptoms of this condition may include swelling or redness of the vulva, perineum, or inner thighs.
- The cause of this condition is often not known. Many factors may contribute to it. Vulvar pain may be a type of nerve pain (neuropathic pain).
- Treatment depends on the cause and severity of your pain. It may include working with a pain specialist, physical therapy, counseling, complementary medical therapies, or surgery to remove affected parts of your vulva.