Vulvodynia

Vulvodynia is defined as a discomfort in the vulvar area per a minimum of 3 months, that is why it is considered a form of chronic pelvic pain. According to studies, 16% of women can be affected by this disease.

Its origin is still unknown eventhough it is considered as multi-factorial: embrinonary origin, chronic inflammatory process, immune genetical factors, environmental factors (infections, irritating substances use, trauma), hormonal changes and the human papillomavirus infection.

It is manifested as pain in the vulvar area that can come in various forms such as heat, inflammation, throbbing sensation, itching, and pain during sexual intercourse (dyspareunia).

Diagnosis is reached through clinical history, a gynaecologic exploration and by ruling out other causes. A meticulous evaluation of the pain history, sexual history, clinical situation and physical examination are basic elements to reach a well-thought diagnosis. It is very important to identify and treat all the specific treatments that may be originating the pain before declaring it is actually vulvodynia.

The main objective of the treatment is reduce pain, improve life quality and recover the sexual function if this has been affected.
A series of different measures applicable to all the cases has to be taken into consideration:

• Use only towels made with cotton.
• Use only underwear made with cotton and wash it throughly to avoid remains of detergent or softener.
• Use lubrication in your sexual relationships.
• Do not douche or use soaps in the genital area, only water and dry using a soft towel.
• Use soft soaps while showering, in general.
• Avoid using tight underwear or trousers in the genital area.

A good treatment requires a multidisciplinary focus that include prevention measures, psychological treatment, pelvic floor physiotherapy and medical therapy (local analgesics, anti-inflammatory drugs or antidepressants). In selected cases, a perineal surgery or vestibulectomy can be taken into consideration.