What is vulvodynia?
vulvodinia is a chronic painful condition affecting the vulvar area, often without an identifiable cause. It manifests as burning, itching, stinging sensation or irritation and can last for months or years, significantly affecting women’s quality of life. This syndrome may be accompanied by vulvo-vaginal dryness and atrophy, further worsening the symptoms
Spread of vulvodinia around the world
vulvodinia is an underdiagnosed problem, affecting between 12% and 16% of women globally. In some countries, such as the United States, it is estimated that about 1 in 10 women may suffer from it during their lifetime. However, many cases go undiagnosed due to poor medical and social awareness
Vulvodynia: the age groups involved
vulvodinia can occur at any age, but is most common between the ages of 20 and 50. In particular: – Young women: pain often appears after the first sexual experience or the use of tampons. – Postmenopausal women: at this stage of life, the risk increases due to vulvo-vaginal dryness and atrophy related to the decline in estrogen
Types of Vulvodynia
vulvodinia is divided into two main subtypes
- Provoked vestibulodynia (VBD): pain localized to the vulvar vestibule, usually triggered by contact, such as sexual intercourse, insertion of tampons, or gynecological examinations.
- Generalized vulvodynia: spontaneous pain involving the entire vulvar area and, in some cases, extending to the thighs or perineum.
Symptoms of Vulvodynia
Symptoms vary from woman to woman, but generally include
- Chronic vulvarpain (burning, stinging, irritation).
- Dyspareunia (pain during sexual intercourse).
- Vulvo-vaginaldryness.
- Sensitivity to even light contact.
- Irritation after use of cleansers or tight clothing.
These symptoms can affect the ability to perform daily activities such as walking, sitting for long periods, or wearing tight underwear
Causes of Vulvodynia
The causes of vulvodinia are not fully understood, but are believed to be multifactorial. Among the main triggers are
- Neurological alterations: hypersensitivity of nerve fibers in the vulvar area.
- Hormonal imbalances: related to taking oral contraceptives or menopause.
- Pelvic floor dysfunction: muscle spasms causing pain.
- Chronic inflammation.
Diagnosis of Vulvodynia
The diagnosis of vulvodinia is often a diagnosis of exclusion. The gynecologist may perform the cotton swab test, which involves pressure on different areas of the vulva with a swab to locate painful areas. It is critical to consider the presence of vulvo-vaginal dryness and atrophy, especially in postmenopausal women, as these conditions can worsen symptoms
Treatments for Vulvodynia
- Lidocaine 5%: reduces pain when applied locally.
- Estrogen or hyaluronic acid creams: useful for treating vulvo-vaginal dryness and atrophy.
- Gabapentin and amitriptyline: drugs used to treat neuropathic pain.
2. Physical Therapies– Pelvic floor physiotherapy: Helps reduce muscle tension and improve sexual function – Biofeedback: A technique that teaches how to relax pelvic muscles to reduce pain
Psychological and Relational Impacts of vulvodinia
vulvodinia can impair intimacy, mental health and quality of life. Affected women may suffer from anxiety, depression, and social isolation. Partners of affected women may also experience psychological distress and relationship difficulties
Tips for Prevention and Management of Dryness and Atrophy
To reduce the risk of worsening symptoms, it is helpful to take some preventive measures
- Moisturize mucous membranes: use lubricants and emollient creams.
- Avoid harsh cleansers: prefer gentle, fragrance-free products.
- Wear cotton underwear: avoid synthetic materials and overly tight clothing.
- Use lubricants during sexual intercourse: reduces the risk of microinjury.
Combined management of vulvodinia, dryness and vulvo-vaginal atrophy, along with psychological support, can significantly improve the quality of life of women with this condition.
