Gynecological diseases affect the female reproductive system, namely the uterus, vagina, vulva, ovaries and fallopian tubes. Certain affections of the female genital system are now known to the general public. This is the case with endometriosis, prolapse, polycystic ovary syndrome (PCOS) or uterine fibroids. But these diseases are not the only ones that can suffer from women. Among the gynecological pathologies about which little is said, we find cancer of the vulva, Rokitansky syndrome but also vulvodynia, also called "depression of the vagina". The term vulvodynia is literally defined as "pain of the vulva".
What is vulvodynia?
Vulvodynia is pain in the vulva with no identifiable cause. This pain can persist for more than three months and even last for several years. The vulva is the female genital area that can be seen on the outside of the body. The latter is made up of the vagina, labia majora, labia minora, clitoris, perineum, anus, Bartholin's glands, as well as the urethral and vaginal orifice.
According to the French Society of Dermatology, this disease results from a dysfunction of the pain modulation system. Normally, pain is a warning signal: it warns that there is tissue damage. But during vulvodynia, the brain receives the information 'pain' in the absence of any tissue damage and pain-blocking mechanisms are faulty ", can we read on his site.
There are two types of pain that can sometimes go away on their own. The first, which characterizes "vestibulodynia", is caused by contact, such as touch, friction or pressure, during sex or during the insertion of tampons, for example. In this case, the pain is localized in the vestibule, or at the entrance to the vagina. This type of pain mainly affects young women. "The provoked vulvodynias have a significant psychological and sexual repercussions", the French Urology Association said on its website.
The second form, called "dysesthetic vulvodynia", affects the entire vulva. The pain appears spontaneously and may be worsened upon contact. This form is found mainly in postmenopausal women.
Vulvodynia: what are the causes?
The exact cause of vulvodynia has not been identified. But according to the French Society of Dermatology, certain inflammatory diseases, such as cancer, precancerous conditions, lichen planus or infections such as recurrent mycosis, can cause persistent vulvar pain. The Foundation for Continuing Medical Education (FMPE) has indicated that the cause of the disease may be hypersensitivity to pain in the nerve endings of the vulva and / or overactive pelvic muscles.
What are the symptoms of vulvodynia?
Vulvodynia manifests as pain, which can be spontaneous and constant or occur to touch. The latter can be slightly uncomfortable on some days and intense on other days. When the pain is severe, it can prevent the woman with the pain from sitting or sleeping. Pain can be accompanied by:
- From a burning sensation
- Tingling
- Tugging
- From a drought
- Sore vulva
- Strains or abnormalities in the control of the perineal muscles that surround the vulva
According to the French Society of Dermatology, women with vulvodynia are also more likely to suffer from joint and muscle pain, lower abdomen pain and irritable bowel syndrome. They also frequently want to urinate.
Vulvodynia: how to diagnose it?
To diagnose vulvodynia, the doctor performs a physical examination. He asks the patient to perform additional examinations to rule out inflammatory, cancerous, infectious or traumatic causes of persistent vulvar pain. He then finds that the patient's examination is normal. "It is important that the doctor does not question the reality of the pain. (…) Vulvodynia can be associated with another disease (lichen, recurrent mycosis). The doctor then establishes that the identified disease cannot explain to her only persistent pain ", explained the French Society of Dermatology.
How to treat vulvodynia?
To manage vulvodynia, the healthcare professional must take into account the different consequences of this persistent pain in the vulva. The practitioner may suggest that the patient hydrate the mucosa well with lubricants during intercourse, local estrogen or moisturizers. To relieve the pain during sex, the doctor may prescribe a local anesthetic. He may also suggest and administer oral analgesics to the patient.
Other treatment: perineal rehabilitation sessions by a physiotherapist with knowledge of this disease. These sessions help reduce muscle spasms. The patient may also use certain devices, such as a donut-shaped cushion, to make sitting more comfortable and avoid sitting on the painful area. "Acupuncture, especially when pain is constant, can relieve symptoms by 'deactivating' overactive nociceptive nerve fibers," specified the Foundation for Continuing Medical Education (FMPE).
The patient must also be followed by a psychotherapist. During the consultations, she will learn to cope with these persistent vulvar pain through relaxation, meditation or hypnosis. A woman with vulvodynia and her partner can also be accompanied by a sex therapist.
Read also :
⋙ Vulvar cancer: what symptoms should alert you?
⋙ Vulvar lichen sclerosus: how to recognize this chronic inflammation of the vulva?
⋙ Intimate hygiene: 6 tips from a gynecologist to take care of her vulva