Vulvodynia: Acute, Chronic and Mysterious Vaginal Pain

Imagine one day waking up to a horrible pain that feels like a needle being scraped inside your vagina. It burns, and it stings. But there doesn’t seem to be anything observably wrong. There is no inflammation, swelling, or discoloration. There is no bleeding or discharge. In short, except for the pain, everything seems to be perfectly normal.

The pain doesn’t go away after a few days, so you decide it’s time to seek medical attention. If this scenario happened a decade or so ago, you would probably have been told that the agonizing pain was likely to be psychosomatic. Even today, you might experience significant difficulty in obtaining accurate diagnosis and effective treatment for the painful condition known as vulvodynia.

What is this burning, stinging pain in my vagina?

Vulvodynia is a real, debilitating condition that seems to appear from nowhere and demonstrates no observable symptoms. And it’s more common than you might think. About one out of every six women will experience vulvodynia at some point in their lifetime. Although vulvodynia occurs in women of all ages, and doesn’t discriminate between ethnicities, most women start noticing symptoms between the ages of 18 and 25.

Vulvodynia impacts nearly every aspect of a woman’s life. Take it from Lauren Ferrier, who first developed symptoms at age 14: “The burning was off and on, but when it was full-blown, it left me in excruciating pain every time I sat down, like a nail was scratching the inside of my vagina.”

The prospect of inserting a tampon filled her with dread, and sexual contact with her boyfriend was completely out of the question. “I avoided getting intimate with anyone because of my embarrassing condition that seemed to have no name,” she said.

Since vulvodynia is not easily detected, over the years doctors have developed their own approaches to understand and treat the condition. Many believe there is a neurological component that triggers the sensitive nerves in the vulva, causing pain that feels like a terrible UTI or yeast infection.

Vulvodynia has proven to be a difficult diagnosis

Many women say the trickiest and most frustrating part of having this condition was getting a doctor to take her seriously. Even as recently as ten years ago, vulvodynia was relatively unheard of. Patients often visited many doctors before getting an accurate diagnosis.

Although the pain can begin misleadingly, by exhibiting some of the symptoms of a urinary tract infection or a yeast infection, the usual treatments for those conditions, are, of course, completely ineffective against vulvodynia. Indeed, they often make the pain worse.

What causes vulvodynia?

Even now, no one is really sure what cases the condition. Although some women say that their vulvodynia was triggered by penetration by a tampon, finger, or penis, most victims feel just fine one day, and the next day they are in excruciating pain.

The National Vulvodynia Association, an organization committed to researching and disseminating awareness about the condition, says that one or a combination of the following occurrences can initiate vulvodynia:

• An injury or irritation to the vulvar nerves
• An abnormal reaction by the vulvar cells to trauma or infection
• Spasms in the pelvic floor muscles
• Genetic abnormalities
• A hypersensitivity to vaginal yeast

Treating the physical pain of vulvodynia

Treatment for vulvodynia includes both medicinal and physical therapy. In about 70% of patients, application of a compound cream containing gabapentin, amitriptyline, and baclofen results in significant improvement within six months.

Various modes of physical therapy can help patients to rehabilitate their pelvic floor muscles. Physical therapists report that massage and ovular plastic expanders, to stretch and relax the vagina, are effective. As a last resort in cases where the pain is localized in the opening to the vagina, a surgical procedure provides a 60% to 90% success rate.

MonaLisa Touch CO2 laser helps eliminate the pain of vulvodynia

The newest and most promising treatment for vulvodynia is the MonaLisa Touch, a gentle laser therapy that delivers controlled energy to the affected area. It restores vaginal health by regenerating vaginal tissue, increasing elasticity, and restoring healthy blood flow. The procedure requires only local anesthesia, such as topical lidocaine. Although some patients report mild discomfort the first time the CO2 fractional laser dissemination probe is inserted, the treatment itself is not at all painful.

MonaLisa Touch is an in-office procedure, consisting of three treatments scheduled approximately a month apart, with each treatment taking only about five minutes. Any side effects are generally minor, and usually resolve within a week. Many of Dr. Aliabadi’s patients have achieved very successful results with the MonaLisa Touch.

Treating the emotional pain of vulvodynia

Untreated vulvodynia will profoundly diminish your life, not least by squelching your libido. This can estrange you from a current romantic partner, and discourage any attempts to meet potential new partners. The inevitable results are loneliness and depression, so emotional support is an essential component of a successful treatment program. That’s why Dr. Aliabadi may recommend anti-depressants to raise your serotonin levels, while together you work to conquer the pain.