Vulvodynia is a chronic pain condition affecting the area around the opening of the vagina, the vestibule, and sometimes spreading farther to cause pain in the perineum, the labia and the clitoris. The cause of this condition is not usually known, and pain may be constant or associated with sexual intercourse. Given that so little is known about the condition, vulvodynia treatment is diverse and not all women opt for the same treatment. It’s virtually impossible to say which vulvodynia treatment women should choose, since responses to treatments can be varied.
A number of different vulvodynia treatment options are available, and knowing these can be helpful in trying to make a choice. These treatments are presented in broad strokes, and patients should always consult with doctors about each type. New ideas may come along for how to more effectively manage or treat vulvodynia in the future, and it’s always best to regard new medical advice prior to deciding what may work. It’s also important to note that some women may go through several treatment options prior to finding one that is effective. This can be frustrating, especially given a chronic pain state, but it is common.
There are many medications that may be used separately or together as vulvodynia treatment. These can include pain medications like opiates, although these are not preferred for long-term use. Some forms of antidepressants including tricyclic antidepressants and serotonin norepinephrine reuptake inhibitors (SNRIs) could be used on a long-term basis as they may occasionally reduce chronic pain. Anticonvulsants are another option, particularly gabapentin (Neurontin®). Ointments could also be applied to the vulva and any painful areas and these might have short-acting numbing effects or might include hormones like estrogen.
Numbing medications may also be injected to block nerve sensations; the most of common of these is a pudendal nerve block. Sometimes doctors use a sequence of nerve blocks over a period of several days or weeks to calm the nerve tissue. This might eliminate a flare of extreme pain. It may require hospitalization, since nerve blocks like epidurals paralyze the body from the waist down.
Medications might be used with a variety of physical therapy techniques to help strengthen the pelvic floor. Medication use and psychological therapy are very often recommended. In fact, no matter what vulvodynia treatment is tried, therapy may be very helpful, since the condition can make some things hard or impossible like sexual intercourse, which may create relationship damage or sense of poor self esteem or grief.
Another potential vulvodynia treatment is a vestibulectomy, which removes tissue surrounding the vagina. There are different reports on success rate for this surgery, and they range from a 60-80% success rate. Those interested in this surgery should discuss the success rate of the procedure with the surgeon who will be performing it, since individual percentages can vary.
There are other less standard treatments that may be tried too. Perhaps one of the best sources for information on treatments, aside from doctors, is the National Vulvodynia Associate website. It contains extensive literature on the topic, and also has supportive literature for women who suffer from this condition.