Tonight, in our BC ECHO for pain meeting, our topic is vulvodynia. This is the sensation of either burning, stinging, or sensitivity in the vulva area. Pain can occur spontaneously, or after sitting for long periods, intercourse, bicycle riding, tight clothes, using a tampon, or even a light touch.
This diagnosis is made once a healthcare provider has eliminated dermatological causes, infections, or an acidic diet. Some people with this condition have associated vaginismus, uncontrollable muscle spasms of the vagina, another often painful condition.
Individuals with depression have a 53% higher prevalence of vulvodynia than those who don’t present with depression. People with PTSD are twice as likely to have vulvodynia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4628213/ . Those with complex PTSD, where they grew up with fear, have three times the likelihood of having vulvodynia. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4129923/
Treating spontaneous vulvodynia has a similar approach to treating chronic pain. Medication can help, especially those medications that soothe the nervous system, like tricyclic antidepressants, duloxetine, selective serotonin and norepinephrine reuptake inhibitors, SSRIs and anticonvulsants.
Of course, medication is not the only tool, and, for some people, these medications have intolerable side effects. This is especially true of people who have pain to touch. Pelvic floor exercises, biofeedback, and physiotherapy can be incredibly helpful.
Ice can be used to manage the pain, if that doesn’t help, try heat. It is not advisable to use lidocaine to have intercourse as intercourse can cause more pain.
Cognitive behaviour feedback is also valuable.
These tools can all be helped if you are able to Calm your Limbic System.