What is vulvodynia?
Vulvodynia (vul-vo-din-ee-uh) is a complex chronic pain syndrome occurring around the vulva lasting at least 3 months in duration. It has no known cause, and is usually diagnosed by a medical provider after other infection and skin disorders have been ruled out.
People describe the pain as severe in nature, often using the word burning or stabbing to describe their pain. It has two main subtypes: generalized and localized.
So what is the difference between generalized and localized vulvodynia?
Generalized Vulvodynia
includes pain that occurs at any point along the vulvar area, with multiple points often occurring at once, which is the external genital area of a person with a vagina. The vulva includes the inner and outer “lips” which are the labia majora and labia minora, the vestibule and the introitus.
Localized Vulvodynia
Localized vulvodynia is pain occurring at only one vulvar site. This includes vestibulodynia, which is pain occurring around the opening of the vaginal canal (the vestibule) after activities such as penetrative sexual activity, tampon insertion, medical exam or even wearing tight clothing. Another type of localized vulvodynia is called cliterodynia, where pain occurs in the clitoris.
Since vulvodynia is complex in nature, often a multidisciplinary treatment approach works best. Practitioners include pelvic floor physical therapists, sex therapists, social workers trained in Cognitive Behavioral Therapy (CBT), pain management specialists and gynecologists. Treatment is geared towards reduction of symptoms, improved quality of life and improved sexual function, which can often take a combination of treatments to create relief.
Pelvic Floor physical therapy in this instance would focus on neural downtraining of the pelvic floor to reduce myotension of the musculature and desensitize the affected parts of the vulva to further reduce pain intensity.
Vulvodynia is very complex and can affect many people in the population, but pelvic floor physical therapy can help reduce symptoms as part of a wholistic multidisciplinary treatment approach! If you have any further questions contact me at CSCM today.
References:
- https://www.nva.org/
- Provoked vestibulodynia: current perspectives PMID: 28979166
