The Benefits of a Multidisciplinary Approach to Vulvar Pain Treatment
As a Vulva Pain Doctor will tell you: “Vulvodynia (i.e. chronic vulvar pain without identifiable cause), is a heterogeneous clinical entity with a complex multifactorial causation. It is long lasting & difficult to treat, & the general consensus of current guidelines states that patients with vulvodynia benefit from a compound multidisciplinary intervention targeting mucosal hypersensitivity, pelvic muscle floor dysfunction, & general pain management” [1]
Putting a Spotlight on Different Treatment Modalities
As Harvard Medical School notes: “a multidisciplinary model of care typically combines psychotherapy, physical therapy, and medical management. High-quality, biopsychosocial care improves patients’ sexual health and quality of life, and these benefits may also be experienced by their intimate partners [2].
Of note, everyone is different, and it is only after you have received an accurate diagnosis from a Vulva Doctor (who will review your medical history, conduct an examination (if necessary), and arrange for any essential scans and tests), that the Vulva Consultant can draw up a Holistic Personalised Treatment Plan. This can include some of the following modalities:
• CBT (cognitive behavioural therapy): is used for the purpose of reducing pain and its accompanying distress, ameliorating sexual satisfaction and function, and bolstering intimate relationships
• Pelvic floor physical therapy: is designed to both relieve pelvic floor muscle spasms, and increase strength and coordination. Studies show that around “76% of women report improvement in pain with intercourse and gynaecological exams, as well as increased sexual satisfaction” [3]
• Muscle relaxants: certain medications, as well as Botox, have proved beneficial. Vulva Pain Specialists frequently administer the latter, as “various studies report significantly improved vulvar pain after the pelvic floor muscles are injected with botulinum toxin” [3]
• Hormonal medication: your Vulva Doctor will determine whether you are a suitable candidate for this form of treatment
• Anti-inflammatory treatment: research supports the use of anti-inflammatory agents
• Pain Blockers: a cutting-edge treatment which is popular with many Pain Doctors [2]
A multidisciplinary model of care typically combines psychotherapy, physical therapy, and medical management. High-quality, biopsychosocial care improves patients’ sexual health & quality of life, & these benefits may also be experienced by their intimate partners [2]
Impact of a Multidisciplinary Vulvodynia Protocol on Sexual Functioning & Dyspareunia
One respected study delivers: “strong support for the efficacy of a multidisciplinary approach (psychological, pelvic floor physiotherapy, and medical management) for improving dyspareunia and all domains of sexual functioning among women with provoked vestibulodynia [3].
References
[1]. MediFind (2023). “Multidisciplinary Treatment of Chronic Vulvar Pain – a Randomized Controlled Study.”
https://www.medifind.com/conditions/vulvodynia/5464/clinical-trial/6631444
[2]. Harvard Medical School Primary Care Review (2020). “Treatment of Vulvar Pain: A Worthwhile Clinical Challenge.”
https://info.primarycare.hms.harvard.edu/review/treatment-vulvar-pain
[3]. Brotto LA, Yong P, Smith KB, Sadownik LA. Impact of a multidisciplinary vulvodynia program on sexual functioning and dyspareunia. J Sex Med. 2015 Jan;12(1):238-47.
https://pubmed.ncbi.nlm.nih.gov/25354520/