Evaluating & Treating Vulvar Pain
“The pathophysiology of vulvar pain is poorly understood, with the result that less than 2% of affected women are properly diagnosed & treated. The diversity of patient characteristics additionally confounds evaluation & effective treatment” [1]
Making Vulvodynia a Household Name
“With a prevalence of up to 20% of the patient population, vaginal pain is deserving of greater clinical attention,” [1], yet at the present time in the UK, there are very few Vulvar Pain Specialists. The most prominent name in the drive for vulvodynia and vulvar pain to be understood, and not dis-guarded as a taboo subject that should be swept under the carpet, is Dr Chris Jenner, MB BS, FRCA FFPMRCA. – The founder and director of the London Vulva Pain Clinic, and the author of the hugely popular book, Viva la Vulva!
Having an Evaluation With a Vulvodynia Pain Specialist
If you have been suffering from chronic vulva pain, and are given an evaluation by a Pain Doctor, they will review your medical notes, and ask you various questions relating to your sexual, surgical, and medical history. Once this has been concluded, they will then conduct a physical examination of your vagina and external genitals, in order to: 1. Look for any symptoms or potential causes of your pain; and 2: To ensure that you do not have an infection, vulvar dermatoses, or primary psychosexual dysfunction [2].
If there are no visual signs of an infection, then the Vulvodynia Consultant may take vagina cell samples, to rule out a hidden infection (such as bacteria vaginosis or a yeast infection). In addition to this, the Vulva Doctor is likely to administer a gentle, cotton swab test. – This will help them ascertain precisely where the localised pain areas are in your vulvar region [2].
What Types of Treatments Can a Vulvar Pain Specialist Give Me?
“For many, a combination of treatments works best. It can take time to find the right treatments, & it can take time after starting a treatment before you notice relief” [2]
Popular treatments comprise:
- Medications: that include steroids, anticonvulsants, tricyclic antidepressants, and antihistamines
- Local Anaesthetics: that involve the use of specific topical medications (such as lidocaine ointment)
- Nerve Blocks: which are local nerve block injections administered by the Vulva doctor
- Pelvic Floor Therapy: which comprises specific exercises to relax and retrain your pelvic muscles [3].
References
[1]. Lamvu, G. M (2017). “Evaluating and Treating Vulvar Pain.”
https://www.painweek.org/media/video/evaluating-and-treating-vulvar-pain
[2]. Judge et al., (2002). “Identifying and Treating Vulvar Pain.” NEGM Journal Watch.
https://www.jwatch.org/wh200201080000013/2002/01/08/identifying-and-treating-vulvar-pain
[3]. Mayo Clinic (2022). “Vulvodynia.”