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Saturday, 5 September 2015

Common Vaginal Problems: Vulvodynia




What is it?
This is a pain syndrome that is described as persistent, unexplained pain in the external female genital organs, including the labia, clitoris and vaginal opening. It can affect women of all ages but usually start in women younger than 25. Most sufferers are otherwise healthy and have no history of STI. Vulvodynia is not contagious and has nothing to do with personal hygiene. It is divided into 2 types

1. Unprovoked or generalised vulvodynia - this is vulva pain that is constant or that comes on spontaneously. It occurs in different parts of the vulva at different times. Touch or pressure may make it worse.

2.Pressure-provoked or vestibulodynia – this is pain in the vulva or vestibule ( where the vulva meets the vagina) that comes on when these areas are touched or pressure is applied, such as during sex or when inserting a tampon.

What causes it?

The cause is not known but a few theories have been put forward such as:

1.     Irritation or damage of the nerves around the vulva

2.     Oversensitivity of the nerve endings in the skin of the vulva

3.     Previous vulva surgery  

4.     Frequent antibiotic use

5.     History of sexual abuse

6.     Hormonal changes

7.     Allergies or irritation to chemicals

8.     Muscle spasms

9.     Hypersensitivity or yeast infections

10.  Genetic factors that make the vulva respond inappropriately to chronic inflammation

11.  Abnormal response in vulva cells to an infection or trauma

What does it look like?

The symptoms have been described as burning, stinging, rawness, aching, soreness, throbbing and itching. Some women have described the pain as knife-like or like acid being poured on the skin even though the outward appearance of the vulva might look normal, although sometimes it might appear swollen and a little inflamed. Vulvodynia symptoms can occur:

•All the time or just once in a while

•During activities such as exercise, intercourse, or walking -- or even while at rest

•While bicycling, inserting tampons, or even sitting

•In one specific area or throughout your entire vulva

How can I get rid of without meds?

There is no cure but there are some lifestyle changes you can make to help prevent and relieve your symptoms

•Wear 100% white cotton underwear, sanitary towels and tampons.

•Avoid scented hygiene products such as feminine wipes, bubble bath and soap – an emollient, such as aqueous cream or e45 is a good substitute for soap.

•Use petroleum jelly before swimming to provide protection from chlorine.

•Avoid activities like cycling and horseback riding that put prolonged pressure on the vulva.

•If sexual intercourse is painful, try to find a position that is comfortable (many women find that being on top is the most comfortable position).

•Try to reduce stress as high levels of stress can increase the pain of vulvodynia

•Use dermatologically approved detergent and don’t use fabric softener on panties.

•Use unscented toilet paper that’s soft and white or better still use unscented flushable toddler wipes..

•Avoid getting shampoo on the vulvar area.

•Avoid perfumed creams or soaps, pads or tampons, and contraceptive creams or spermicides.

•Rinse the vulva with cool water after urination and intercourse.

•Wear loose-fitting pants and skirts; don’t wear pantyhose.

Tried without meds but it’s still there.

·        Local anaesthetics – applying 5% lidocaine ointment to the vulva 10 minutes before sex can make sex more comfortable. Beware, lidocaine can sometimes irritate vulva, also if you are using a condom then wipe off the lidocaine before sex because it can cause the condom to break.

·        Vaginal lubricants and moisturisers.

·        Oestrogen cream

·        Tricyclic antidepressants – these have been known to give some women relief from their symptoms but can cause drowsiness, constipation, weight gain and dry mouth as side effects. Examples include amitriptyline and nortriptyline. They have to be taken under medical supervision.

·        Anti-epileptic meds like gabapentin and pregabalin.

·        Nerve blocks

·        Interferon injections
Copyright June's Secrets 2015

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