HAVING constant pain in the genital area is something that no woman desires, but according to consultant obstetrician/gynaecologist Dr Mandi Elliot, about 15 per cent of women are estimated to have unexplained pain down there.
These women suffer from vulvodynia, which Dr Elliot explains to be, “Chronic pain in the vulvar area, including but not limited to the clitoris, labia and entrance to the vagina.”
The pain is usually persistent for over a three-month period, she says.
While pain in the genital area can be triggered by infections, inflammation, and even sexual intercourse, the peculiar thing about vulvodynia is that the pain comes on unprovoked at times.
Dr Elliot says doctors are still trying to pinpoint a root cause for vulvodynia.
“Many possible causes are being explored such as allergies or irritation to certain chemicals, genetic predisposition to inflammation, nerve injury, hormonal imbalance, muscle spasms, autoimmune disorders and so on,” she says.
“Pain is the defining symptom. It is often described as a burning sensation, soreness or stinging. It may be localised (occurring in one part of the genital area), and triggered by touch and pressure such as intercourse, insertion of tampons, or prolonged sitting.”
She adds that the pain may also be generalised, meaning it occurs in different parts of the vulva. She says that in both cases the pain may be constant or intermittent.
Because the only symptom of vulvodynia is pain, there is no real test to know if you suffer from it, apart from ruling out everything else that could be causing the pain, Dr Elliot notes.
“It is a diagnosis of exclusion, meaning it is based on the patient's complaints or symptoms,” she explains. “It is diagnosed upon finding normal external genitalia by physical examination, when all other known causes of vulvar pain are absent.”
The one thing more painful than being diagnosed with vulvodynia is hearing that you may not be able to escape the pain.
“There is no one-size-fits-all treatment. Usually a combination of therapies is needed. Many medications such as steroids, hormones, botox, antidepressants and analgesics have been tried with little to no success,” Dr Elliot explains.
She says, however, that some women may be able to reduce the chance of the pain flaring up by avoiding known irritants such as certain soaps, douching and spermicides.
“Also the use of cotton underwear, loose clothing, and keeping the vulva clean and dry (ie avoiding sitting in wet bathing suits or gym clothes), and avoidance of activities that put pressure on the vulva such as bike riding, can be helpful,” she adds.
“Although not life threatening, it can cause physical and emotional impairment in a woman's life by affecting her ability to exercise, work, have sex, or enjoy the things she usually does,” Dr Elliot says.