Different Causes of Vulvar pain

Vulvar pain or vulvodynia is a persistent and unexplained pain of the vulva, which is the skin surrounding the vagina. There is as yet no obvious cause to this pain, but help may be provided to relieve the pain so that it no longer problematic. Vulvar pain affects women of all ages, ranging  from 20 to 60, but it often starts in women less than 25 years of age. It can be very distressful and significantly affect the quality of life.

Symptoms of Vulvar pain

The symptoms of vulvodynia often include pain that may be experienced as burning or stinging. The pain may also be of an aching or throbbing nature. Sometimes, the pain may be associated with itching.

The pain may occur constantly, or it may come and go. It can also occur during certain activities including sex or  exercise. It may also take place when at rest. Some women complain of pain that is concentrated to one side or one area of the vulva, while others experience a more generalized and widespread pain.

There are generally no physical signs or changes that might accompany vulvodynia, but sometimes there may be evidence of inflamed skin.

Possible Causes

The causes of vulvodynia is yet to be understood. There is a possibility that it is caused by:

•     A nerve problem – Oversensitive nerve endings in the skin of the vulva, irritation or damage of the nerves around the vulva, or (less likely) a trapped nerve in the spine

•     Previous surgery to the vulva- This occurs especially if it resulted in scarring

It is not understood why some women suffer from vulvodynia. It is not considered to be related to sexually-transmitted diseases (STDs), though some women with vulvodynia might have had multiple STDs. Some theories imply that vulvodynia may be related to irritation or damage of nerves, abnormal responses to inflammation or irritation, allergic reactions, a history of sexual abuse, muscle spasms or frequent use of antibiotics. Familial or genetic factors may also play a role in vulvodynia.

Managing Vulvodynia

A combination of treatments can help to get relief from the symptoms of vulvodynia and lessen its impact on our lives. These may include prescription medication, gels and lubricants, and physiotherapy. Some antidepressant relieve the pain of vulvodynia for some women. However, there are possible side effects of drowsiness, weight gain and dry mouth. For some women application of certain anaesthetic gels  to their vulva 15–20 minutes before sex may make intercourse possible, although there can sometimes irritation in the area. Vaginal lubricants and aqueous cream may also soothe the area and help to moisturise the vulva in case of dryness. The physiotherapist may teach some pelvic floor exercises such as squeezing and releasing the pelvic muscles, to help relax the muscles around the vagina. Apart from these certain lifestyle changes may also be helpful, such as using 100% cotton underwear, loose fitting skirts and trousers, avoid scented hygiene products, and avoid prolonged cycling. These remedies may bring relief to the affected person to some extent.