Vulvodynia means vulvar pain or discomfort. People who have vulvodynia often describe a burning sensation, which occurs in the absence of visible or identifiable clinical causes. This means there are no obvious signs or diagnoses to explain the discomfort.
Prevalence and Causes
It’s estimated that around 1.3% of people experience vulvodynia. Unfortunately many suffer in silence, not knowing where to seek help.
Despite ongoing research, the exact cause of vulvodynia remains unclear. It’s believed to arise from a combination of factors, which may include:
- genetic predisposition
- nerve damage
- hormonal changes
- allergic reactions
- pelvic floor muscle tension
- nerve entrapment
Importantly, there are misconceptions about vulvodynia that need to be addressed. Conditions like HPV (human papilloma virus), urinary oxalate buildup, and candidiasis (yeast infections) are not causes of vulvodynia. Furthermore, psychological or sexual dysfunction, although often present, is not the underlying cause of vulvodynia.
Treatment Options for People who have Vulvodynia
Managing vulvodynia often requires a multifaceted approach, as the pain can vary from mild to severe and can have a significant impact on daily life. At Pelvic Health Physiotherapy, we work with other health professionals so that you get all the help you need.
Topical anaesthetics
Some people find relief through topical anaesthetics, which can temporarily numb the affected area. Medications that have been used include a variety of creams and ointments containing ingredients such as e.g. estradiol, capsaicin, and lignocaine.
Low doses of antidepressant medications
Antidepressant medications (in lower doses than what is used to treat depression) are commonly prescribed for managing chronic pain conditions like vulvodynia e.g. amitriptyline or nortriptyline. These can help block the nerve signals that contribute to pain. Gabapentin is another option for nerve-related pain.
How Pelvic Health Physiotherapy Can Help when you have Vulvodynia
Pelvic health physiotherapy is a highly effective treatment option for managing vulvodynia.
Physiotherapists work to address the physical factors contributing to pain, such as:
- tight pelvic floor muscles
- poor posture
- reduced blood flow to the vulvar tissues
The goal is to relieve muscle tightness, improve pelvic floor function, increase blood circulation, and promote tissue healing.
A skilled pelvic health physiotherapist will conduct a thorough assessment, and based on this, will give you a personalised treatment plan that targets your specific needs. We often see significant pain relief and improved function.
Other Treatment Options
In some cases, more advanced treatment such as botulinum toxin A (Botox), is used. Botox injections have been shown to reduce pain for some people, particularly when used in combination with pelvic floor physiotherapy. Botox is typically reserved for cases where muscle tightness remains unresponsive to other treatments. So the specialists we work with will send their patients to see us for a trial of physiotherapy first, before they try Botox as a treatment.
Conclusion
Vulvodynia can be a challenging condition to manage, but there are effective treatments available. Pelvic health physiotherapy is one of the most promising, helping to alleviate pain, restore pelvic function, and improve quality of life.
If you’re experiencing vulvar pain, come and see us – we are specialised and highly experienced pelvic health physios and we see many people with this condition.