Mindy was in her mid-thirties when suddenly intercourse started to be painful. Without a triggering event, she asked her healthcare provider what could possibly wrong with her body and her sexual response?
Mindy is actually one of many women who experience pain on the vulva or entrance to the vagina at some time in their lives. In fact, 30% of American women do at some point. The pain can persist for many years and may make intercourse almost impossible, and pelvic exams can be very painful. So what is this condition and why does it cause so much suffering?
Understanding vulvar pain
There is some confusion among health care providers about what to call this pain, but most refer to it as vulvodynia or vulvar pain. There are numerous causes suggested for the pain including inflammation of tissues, changes to nerves supplying the area or psychological trauma such as sexual abuse. If you have vulvar pain, your pain may have been triggered by oral contraceptives, yeast infections, human papilloma virus (HPV), tight fitting clothes or chemical irritants such as bubble baths, scented soaps or detergents.
You may experience vulvar pain as a burning, stinging sensation on the vulva. Intercourse is usually very painful, and this is what often causes women to see help.
During an exam, your healthcare provider will look for redness in the vulvar tissue or touch the area with a Q-tip to test your sensitivity and pain response. Living with unresolved vulvar pain can cause depression, a reduced quality of life, relationship stress and a poor body image. You can help prevent vulvar pain from ever developing by avoiding chemical irritants and wearing loose cotton underwear and clothing.
Treating vulvar pain
Sadly, this condition is usually difficult to treat and most women have to try many different therapies before finding relief. Lidocaine cream can be used to numb the area before sexual activity. Some health care providers will prescribe oral medications such as gabapentin or tricyclic anti-depressants. Even though these medications aren’t specifically for these types of pain, they have been effective in some women with vulvodynia.
Pelvic floor physiotherapy with biofeedback has been shown to be quite effective. Surgery is a last resort and has not been shown to be helpful, but women are often so desperate that they will try anything.
If you’re experiencing vulvar pain, keep working with your healthcare provider to help manage the symptoms and treat the cause, as possible. There are a number of useful organizations where you can find additional information about vulvar pain and vulvodynia, including:
