Does Vulvar Pain Come & Go During Menstruation?
“Cyclic vulvitis (a subset of vulvodynia), describes recurrent vulvar pain which comes & goes with a woman’s menstrual cycle. Pain generally tends to be worse right before monthly menstruation starts. Women with cyclic vulvitis (also known as cyclic vulvovaginitis), typically complain of recurrent itching & burning, often worsening with menses & after coitus” [1, 2]. If you suffer from this condition, the best course of action is to contact a Vulvodynia Specialist as soon as possible
The 3 Key Causes of Cyclic Vulvitis
• Cyclic vulvovaginal candidiasis (also known as vulvovaginal candidiasis)
• Cytolytic vaginosis
• Autoimmune progesterone dermatitis [3].
Who Gets Cyclic Vulvitis?
This unwelcome condition can affect menstruating women of all ages [3].
Putting a Spotlight on the Causes & Development of Cyclic Vulvovaginitis
These may include:
• Candida infection and irregular host response
• Bacterial (lactobacilli) overgrowth
• Adverse response to progesterone generated during the luteal stage of the menstrual cycle [3].
What Symptoms Of Cyclic Vulvitis I Should Look Out For?
•Itching, stinging, irritation, and/or intense burning, just prior to (luteal phase) or during menstrual bleeding
•Patients may not experience any symptoms throughout the rest of their menstrual cycle
•Pain is normally worse after sexual intercourse, and can be exacerbated by sexual activity
•Vaginal discharge may be negligible
•Vulval odema, erythema, and/or fissuring, may be present upon examination by a Vulva Specialist [3].
Complications of Cyclic Vulvovaginitis
•Generalised vulvodynia or localised provoked vestibulodynia
•Vaginal discharge which generates contact dermatitis (a second irritant)
•Reduced quality of life [3].
How Does a Vulva Pain Specialist Diagnose Cyclic Vulvovitis?
In order to establish a clinical diagnosis, the Vulva Pain Consultant will first review your medical history; and then, (if necessary), give you an examination. They will check for provoked vulvodynia by conducting a simple Q-tip test. During your symptomatic phase, the Pain Specialist will carry out other tests using vaginal swabs etc., and if the results are negative, these will be repeated once again during the asymptomatic phase.
Once you condition has been correctly diagnosed, the Pain Consultant will devise a personalised Treatment Plan. This may involve more than one type of treatment. They will be very sensitive to your condition, and always explain everything in simple layman’s terms.
References
[1]. Christiano, D. (2019). “Vulvar Pain: Symptoms, Causes, and More.” Healthline.
https://www.healthline.com/health/womens-health/vulvar-pain
[2]. V. L. Handa & C.W. Stice. “Fungal Culture Findings in Cyclic Vulvitis.” Obstetrics & Gynecology: August 2000 – Volume 96 – Issue 2 – p 301-303.
https://journals.lww.com/greenjournal/Abstract/2000/08000/Fungal_Culture_Findings_in_Cyclic_Vulvitis.28.aspx#:~:text=Cyclic%20vulvitis%2C%20a%20subset%20of,discrete%20episodes%20of%20vulvar%20discomfort.&text=Women%20with%20cyclic%20vulvitis%20typically,w
[3]. DermnetNZ (2022). “Cyclic vulvovaginitis.”
“https://dermnetnz.org/topics/cyclic-