VULVADYNIA (VULVAL PAIN)

Vulvodynia is persistent, unexplained pain in the vulva. The vulva is the female genital area including the skin surrounding the opening of the vagina.

It can happen to women of all ages. Vulvodynia can become a long-term problem that's very distressing to live with, but much can be done to help relieve the pain.

Symptoms of vulvodynia

The main symptom is persistent pain in and around the vulva and vagina. The vulva usually looks normal.

The pain may be:

• Burning, stinging, throbbing or sore
• Triggered by touch, such as during sex or when inserting a tampon
• Constantly in the background
• Worse when sitting down
• Limited to part of the vulva, such as the opening of the vagina
• More widespread – sometimes it can spread over the whole genital area and the anus.

Some women also have problems such as vaginismus (where the muscles around the vagina tighten involuntarily), interstitial cystitis (a painful bladder condition), painful periods and irritable bowel syndrome (IBS).

Having persistent vulval pain can affect relationships, reduce sex drive, and cause low mood and depression.

Pain in the genital area is often embarrassing to talk about and can make you feel isolated.

Things you can do to help with vulvodynia

If pain persists you can seek advice from the GP and/or Physiotherapists however there are lifestyle changes may help reduce symptoms:

• Wear cotton underwear and loose-fitting skirts or trousers
• Avoid scented hygiene products, such as feminine wipes, bubble bath and soap (an emollient is a good substitute for soap)
• Apply cool gel packs to your vulva to soothe the pain
• Use petroleum jelly before swimming to protect the vulva from chlorine
• Try not to avoid sex or touching your vulva completely, as this may make your vulva more sensitive. If sex is painful, try to find a position that's more comfortable, or do other sexually intimate activities together until you have sought advice if penetration is painful
• Try to reduce stress, as it can increase the pain of vulvodynia
• For pain when sitting, using a doughnut-shaped cushion can help.

Physiotherapy

A physiotherapist can teach you some pelvic floor exercises (such as squeezing and releasing your pelvic floor muscles) to help relax the muscles around your vagina.

Another technique to relax the muscles in the vagina and desensitise it involves using vaginal trainers. These are smooth cones of gradually increasing size and length that can be inserted into your vagina in the privacy of your own home.

Some physiotherapists may also suggest trying TENS (transcutaneous electrical nerve stimulation) to reduce your pain. This is where a machine is used to deliver a mild electrical current to the painful area.