Materiały źródłowe

• #1 Vulvodynia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430792/

  Vulvodynia is a chronic pain condition characterized by persistent vulvar discomfort or pain lasting at least 3 months without a clearly identifiable cause. […] Although the exact cause of vulvodynia remains unknown, potential contributing factors include nerve dysfunction, inflammation, hormonal imbalances, genetic predisposition, and pelvic floor muscle dysfunction. […] The exact cause of vulvodynia remains unknown, and ongoing research aims to identify potential contributing factors. Possible contributing causes include nerve injury or irritation affecting the transmission of pain from the vulva to the spinal cord, an increase in the number and sensitivity of nerve fibers in the vulva, elevated levels of inflammatory substances such as cytokines, abnormal responses to environmental factors, genetic susceptibility, and pelvic floor muscle weakness, spasms, or instability. […] Although the exact origins of vulvodynia remain unclear, research suggests a multifactorial etiology, including nerve dysfunction, inflammation, and hormonal imbalances. […] The cause of vulvodynia remains unknown, and its treatment continues to be challenging.

• #2 Etiology, diagnosis, and clinical management of vulvodynia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4014358/

  Chronic vulvar pain or discomfort for which no obvious etiology can be found, ie, vulvodynia, can affect up to 16% of women. […] The etiology is multifactorial and may involve local injury or inflammation, and peripheral and or central sensitization of the nervous system. […] The etiology of vulvodynia is uncertain and likely multifactorial. There is debate about whether the pain is primarily caused by a local insult or injury, or a maladaptive peripheral and/or maladaptive central pain processing mechanism. […] At a local level, there may be an initial trigger that causes inflammation and/or injury affecting the vulva. This results in repetitive stimulation of pain receptors and ultimately receptor or nerve damage (nociceptive pain). […] Allergic contact dermatitis and yeast or other urogenital infections have all been proposed as causes for inflammation.

• #3 Persistent Vulvar Pain | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/09/persistent-vulvar-pain

  Vulvar pain can be caused by a specific disorder or it can be idiopathic. Idiopathic vulvar pain is classified as vulvodynia. […] The classification of vulvodynia is based on the site of the pain; whether it is generalized, localized, or mixed; whether it is provoked, spontaneous, or mixed; whether the onset is primary or secondary; and the temporal pattern (whether the pain is intermittent, persistent, constant, immediate, or delayed). […] Vulvodynia is a diagnosis of exclusion. Thus, excluding other treatable causes before assigning this diagnosis is imperative. […] A musculoskeletal evaluation would help rule out musculoskeletal factors associated with vulvodynia, such as pelvic muscle overactivity and myofascial or other biomechanical disorders. […] Medications used to treat vulvar pain include topical, oral, and intralesional medicinal substances, as well as pudendal nerve blocks and botulinum toxin. Tricyclic antidepressants and anticonvulsants also can be used for vulvodynia pain control.

• #4 Etiology, diagnosis, and clinical management of vulvodynia | IJWH

  https://www.dovepress.com/etiology-diagnosis-and-clinical-management-of-vulvodynia-peer-reviewed-fulltext-article-IJWH

  Chronic vulvar pain or discomfort for which no obvious etiology can be found, ie, vulvodynia, can affect up to 16% of women. […] The etiology is multifactorial and may involve local injury or inflammation, and peripheral and or central sensitization of the nervous system. […] Women with vulvodynia are often very distressed about not being able to identify a cause for their pain. The etiology of vulvodynia is uncertain and likely multifactorial. There is debate about whether the pain is primarily caused by a local insult or injury, or a maladaptive peripheral and/or maladaptive central pain processing mechanism. […] At a local level, there may be an initial trigger that causes inflammation and/or injury affecting the vulva. This results in repetitive stimulation of pain receptors and ultimately receptor or nerve damage (nociceptive pain).

• #5 Etiology, diagnosis, and clinical management of vulvodynia | IJWH

  https://www.dovepress.com/etiology-diagnosis-and-clinical-management-of-vulvodynia-peer-reviewed-fulltext-article-IJWH

  The chronicity of the pain predictably gives rise to significant problems concerning a woman’s psychological, sexual, and pelvic floor health. […] However, the diagnosis and treatment of women with vulvodynia involves recognition and assessment of all the factors influencing her experience of pain.

• #6 Vulvodynia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vulvodynia/symptoms-causes/syc-20353423

  Vulvodynia (vul-voe-DIN-e-uh) is a type of long-term pain or discomfort around the outer part of the female genitals, called the vulva. It lasts at least three months and has no clear cause. […] Experts don’t know what causes vulvodynia. Factors that might play a role include: […] Injury to or irritation of the nerves of the vulva. […] Past infections of the vagina. […] Painful swelling called inflammation that affects the vulva. […] Some genetic conditions. […] Allergies. […] Hormonal changes. […] Muscle spasm or weakness in the pelvic floor, which supports the uterus, bladder and bowel.

• #7 Vulvodynia (vulval pain)

  https://www.nhs.uk/conditions/vulvodynia/

  Vulvodynia is pain in the vulva (area around the outside of the vagina) that lasts at least 3 months and does not have a specific cause. […] The exact cause of vulvodynia is not known. It may be related to a number of things including: damage, irritation or over-sensitivity of the nerves in the vulva; previous vaginal infections; changes in levels of hormones, such as oestrogen; weak pelvic floor muscles.

• #8 Vulvodynia – Wikipedia

  https://en.wikipedia.org/wiki/Vulvodynia

  Vulvodynia is a chronic pain condition that affects the vulvar area and occurs without an identifiable cause. Symptoms typically include a feeling of burning or irritation. It has been established by the ISSVD that for the diagnosis to be made symptoms must last at least three months. […] The causes of vulvodynia are not fully understood, but there are many sub-types of vulvodynia with different causes, including an excess of nerve fibers, hormonal imbalances, inflammation, and muscular dysfunction. Some factors influencing the disease may include genetics, immunology, and possibly diet. […] Vulvodynia has many different sub-types and causes. The disease is highly idiopathic. Identifying the cause is important to determine the appropriate treatment. […] Pain confined to the vulval vestibule, known as vestibulodynia, has at least three known sub-types: neuroproliferation, hormonally-mediation, and inflammation. Neuroproliferation can be present from birth or acquired later in life. This type of vestibulodynia is known as neuroproliferative vestibulodynia. Hormonally-mediated vestibulodynia can be caused by hormonal medications like oral birth control. Inflammatory vestibulodynia can develop as part of an immune response.

• #9 Vestibulodynia | San Diego Sexual Medicine

  https://www.sdsm.info/female-issues/vestibulodynia

  Other research to understand the basis for disease in the vestibule that avoids the tissues of the vulva and the vagina is based on a non-hormonal theory. Multiple investigations have observed a proliferation or growth of pain nerves, called c-afferent nociceptors in the skin layer of the vestibule. In some patients with provoked vestibulodynia, there has been found to exist a 10-fold increase in the density of pain fiber nerve endings in the vestibule skin lining compared to women who did not have provoked vestibulodynia. […] For women with primary or lifetime provoked vestibulodynia, it is felt by some experts that the high density of pain nerves in the vestibule has occurred as the result of a congenital accumulation of nerve fibers, called congenital neuronal hyperplasia, in the tissue derived from the urethral/bladder region or the primitive urogenital sinus.

• #10 Vestibulodynia: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23514-vestibulodynia

  Vestibulodynia is a form of vulvodynia, which causes chronic pain in the vulva. […] Vestibulodynia is a form of vulvodynia or serious and long-lasting (chronic) vulvar pain that occurs for no known reason. […] With both conditions, you experience vulvar pain that doesn’t have an apparent cause. […] Vestibulodynia related to pressure (provoked) is the most common form of localized vulvodynia. […] Experts aren’t sure why certain people experience vestibulodynia. […] It’s possible that some people have a greater number of pudendal nerves in the vulva area. […] Some people experience neuroproliferation (also called neuroproliferative vestibulodynia). […] Vestibulodynia causes neuropathic (nerve) pain that lasts for at least three months. […] Chronic pain from vestibulodynia can be extremely uncomfortable and life-disrupting. […] Vestibulodynia can also lead to sexual dysfunction. […] You may have vestibulodynia, a type of vulvodynia that causes chronic pain at the opening of your vagina (the vestibule).

• #11 Etiology, diagnosis, and clinical management of vulvodynia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4014358/

  Women may identify trauma as precipitating their pain. […] Chronic local inflammation may result in an increase in: neurotransmitters and immune-mediated factors; proliferation of unmyelinated nerve fibers; chronic stimulation of afferent primary c fibers; and chronic stimulation of the dorsal horn cells in the spinal cord. […] Histologic evidence of local changes to the vestibular skin in women with PVD includes chronic inflammatory infiltration, including increased mast cells and plasma cells, and increased nerve fibers. […] Thus, the acute nociceptive pain may result first in peripheral sensitization and ultimately central sensitization, ie, neuropathic pain. […] Women with vulvodynia have been found to have generalized hypersensitivity, a decreased pain threshold in the vulvar area as well as other areas of the body, and enhanced pain processing.

• #12 Etiology, diagnosis, and clinical management of vulvodynia | IJWH

  https://www.dovepress.com/etiology-diagnosis-and-clinical-management-of-vulvodynia-peer-reviewed-fulltext-article-IJWH

  Allergic contact dermatitis and yeast or other urogenital infections have all been proposed as causes for inflammation. […] Other women report the onset of pain to be associated with a hormonal trigger (eg, starting the birth control pill, postpartum amenorrhea, or perimenopause). […] Chronic local inflammation may result in an increase in: neurotransmitters and immune-mediated factors; proliferation of unmyelinated nerve fibers; chronic stimulation of afferent primary c fibers; and chronic stimulation of the dorsal horn cells in the spinal cord. […] Histologic evidence of local changes to the vestibular skin in women with PVD includes chronic inflammatory infiltration, including increased mast cells and plasma cells, and increased nerve fibers. […] Thus, the acute nociceptive pain may result first in peripheral sensitization and ultimately central sensitization, ie, neuropathic pain. This sensitization prolongs the symptoms long after the original tissue injury.

• #13 Etiology, diagnosis, and clinical management of vulvodynia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4014358/

  Women may identify trauma as precipitating their pain. […] Chronic local inflammation may result in an increase in: neurotransmitters and immune-mediated factors; proliferation of unmyelinated nerve fibers; chronic stimulation of afferent primary c fibers; and chronic stimulation of the dorsal horn cells in the spinal cord. […] Histologic evidence of local changes to the vestibular skin in women with PVD includes chronic inflammatory infiltration, including increased mast cells and plasma cells, and increased nerve fibers. […] Thus, the acute nociceptive pain may result first in peripheral sensitization and ultimately central sensitization, ie, neuropathic pain. […] Women with vulvodynia have been found to have generalized hypersensitivity, a decreased pain threshold in the vulvar area as well as other areas of the body, and enhanced pain processing.

• #14 Vulvodynia: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0401/p1231.html

  Although women with vulvodynia were known to be sensitive to touch in the vestibular region, it has only recently become clear that women with vulvodynia also have increased sensitivity at peripheral sites, such as the upper arm or leg. […] The natural history of vulvodynia is not clear. Many women have had this disorder for years, and it traditionally has been considered chronic. However, recent data suggest that approximately one half of women who report that they have had prolonged vulvar pain no longer have symptoms of vulvodynia.

• #15 Etiology, diagnosis, and clinical management of vulvodynia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4014358/

  Women may identify trauma as precipitating their pain. […] Chronic local inflammation may result in an increase in: neurotransmitters and immune-mediated factors; proliferation of unmyelinated nerve fibers; chronic stimulation of afferent primary c fibers; and chronic stimulation of the dorsal horn cells in the spinal cord. […] Histologic evidence of local changes to the vestibular skin in women with PVD includes chronic inflammatory infiltration, including increased mast cells and plasma cells, and increased nerve fibers. […] Thus, the acute nociceptive pain may result first in peripheral sensitization and ultimately central sensitization, ie, neuropathic pain. […] Women with vulvodynia have been found to have generalized hypersensitivity, a decreased pain threshold in the vulvar area as well as other areas of the body, and enhanced pain processing.

• #16 Vulvodynia: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0401/p1231.html

  Vulvodynia is characterized by chronic discomfort in the vulvar region; the discomfort may range from mild to severe and debilitating. […] Although research is ongoing, little is known about the causes of vulvodynia. […] Several studies have identified minor immunologic changes in women with vulvodynia, such as altered levels of interleukin-1 and tumor necrosis factor- in vestibular tissue. […] There is controversy about whether changes exist in the inflammatory infiltrate in vulvar tissue of women with vulvodynia. […] The cause of this increased neuronal density and its role in vulvodynia remain unclear. […] Allodynia (i.e., pain elicited by a nonpainful stimulus) and hyperpathia (i.e., when a stimulus causes greater pain than expected) suggest a neuropathic cause of the pain of vulvodynia.

• #17 Etiology, diagnosis, and clinical management of vulvodynia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4014358/

  Women may identify trauma as precipitating their pain. […] Chronic local inflammation may result in an increase in: neurotransmitters and immune-mediated factors; proliferation of unmyelinated nerve fibers; chronic stimulation of afferent primary c fibers; and chronic stimulation of the dorsal horn cells in the spinal cord. […] Histologic evidence of local changes to the vestibular skin in women with PVD includes chronic inflammatory infiltration, including increased mast cells and plasma cells, and increased nerve fibers. […] Thus, the acute nociceptive pain may result first in peripheral sensitization and ultimately central sensitization, ie, neuropathic pain. […] Women with vulvodynia have been found to have generalized hypersensitivity, a decreased pain threshold in the vulvar area as well as other areas of the body, and enhanced pain processing.

• #18 Etiology, diagnosis, and clinical management of vulvodynia | IJWH

  https://www.dovepress.com/etiology-diagnosis-and-clinical-management-of-vulvodynia-peer-reviewed-fulltext-article-IJWH

  Allergic contact dermatitis and yeast or other urogenital infections have all been proposed as causes for inflammation. […] Other women report the onset of pain to be associated with a hormonal trigger (eg, starting the birth control pill, postpartum amenorrhea, or perimenopause). […] Chronic local inflammation may result in an increase in: neurotransmitters and immune-mediated factors; proliferation of unmyelinated nerve fibers; chronic stimulation of afferent primary c fibers; and chronic stimulation of the dorsal horn cells in the spinal cord. […] Histologic evidence of local changes to the vestibular skin in women with PVD includes chronic inflammatory infiltration, including increased mast cells and plasma cells, and increased nerve fibers. […] Thus, the acute nociceptive pain may result first in peripheral sensitization and ultimately central sensitization, ie, neuropathic pain. This sensitization prolongs the symptoms long after the original tissue injury.

• #19 Vulvodynia: Causes, Symptoms, Management & Treatment

  https://my.clevelandclinic.org/health/diseases/17878-vulvodynia

  Vulvodynia is pain in your vulva that lasts longer than three months. Unlike vulvar pain that results from a condition, vulvodynia doesn’t have a clear cause. The pain can be so life-altering that it keeps you from engaging in activities you enjoy. […] Vulvodynia (pronounced vul-vo-DIN-ee-a) is chronic pain in your vulva, and or vagina or genitals, with no apparent cause. […] Vulvodynia is different. Vulvodynia is pain lasting three or more months that isn’t an obvious symptom of a specific condition. […] Researchers aren’t sure what causes vulvodynia, but there are many potential causes, including: Inflammation, Hormonal factors, Genetic (inherited) factors, Injury to your nerves (neuropathic problems), Long-term reactions to past vaginal infections, Weakened pelvic floor muscles or muscle spasms, Irritation from harsh products that touch your skin.

• #20 Vulvar Pain (Vulvodynia): Symptoms, Causes and Remedies | Carreras Medical Center

  https://www.toplinemd.com/carreras-medical-center/vulvar-pain-vulvodynia-symptoms-causes-and-remedies/

  Recurrent yeast infections: Based on study findings, having more than one yeast infection can boost nerve fiber production in subjects. The nerve fiber increase can result in more pain in the vaginal area. Since this study was not conducted on human subjects, more research is needed to determine the connection between vulvar pain in females and yeast infection. […] Chronic pain conditions: Females experiencing pain in the vaginal area could be two to three times more likely to have conditions such as irritable bowel syndrome or fibromyalgia. Both are inflammatory diseases, so vulvodynia could be linked to inflammation too. […] Hormone therapy: Based on a study, females who have used hormone therapy are more likely to have chronic vulvar pain than those who have not. Another study reports that there is no connection between the use of birth control and vulvar pain.

• #21 Vulvar Pain: Causes, Treatments, and More

  https://www.healthline.com/health/womens-health/vulvar-pain

  Many women experience pain and discomfort in the vulva at some point in their lives. When the pain is persistent for more than three months and has no apparent cause, its called vulvodynia. […] Vulvar pain isn’t well understood. Vulvar pain is not contagious, nor is it spread through sex. Its also not a sign of cancer. […] Researchers have seen a link between vulvar pain and some conditions and factors in some women, such as the following. […] In one study, mice that were subjected to and treated for yeast infections three times were more likely to encounter vulvar pain than mice without yeast infection. The researchers theorized that the multiple yeast infections increased the production of nerve fibers in the mice. The increased nerve fibers resulted in more vulvar pain. […] Some women are born with genetic differences that cause cells to overreact to inflammation or hormones. That can cause pain when inflammation occurs in the vulvar region. Inflammation causes tissue to swell, fill with more blood, and feel hot and sore.

• #22 What Causes Vulvodynia? – The National Vulvodynia Association

  https://www.nva.org/what-is-vulvodynia/what-causes-vulvodynia/

  Vulvodynia is not caused by an active infection or a sexually transmitted disease. […] Through continued research efforts, we move closer to discovering the underlying cause(s) of vulvodynia. Researchers speculate that one or more of the following may cause, or contribute to, vulvodynia: An injury to, or irritation of, the nerves that transmit pain from the vulva to the spinal cord. An increase in the number and sensitivity of pain-sensing nerve fibers in the vulva. Elevated levels of inflammatory substances in the vulva. An abnormal response of different types of vulvar cells to environmental factors such as infection or trauma. Genetic susceptibility to chronic vestibular inflammation, chronic widespread pain and/or inability to combat infection. Pelvic floor muscle weakness, spasm or instability.

• #23 Vulvodynia Demystified: Vulvar Pain Causes and Treatments – ETCOA

  https://www.centerofendometriosis.com/blog/vulvodynia-101-metro-detroit-etcoa/

  Vulvodynia occurs when the vulvar tissue becomes highly sensitive. […] Unfortunately, this condition is still defined as unexplained chronic vulvar pain. We dont know exactly what makes some women experience this sensitivity. […] We do know that it is not caused by active infections, such as a yeast infection, and that it is not a sexually transmitted disease. […] Other possible causes include nerve injuries or irritations, high numbers of pain-sensing nerves in the vulva, allergies or sensitive skin, and hormonal changes.

• #24 Vulvodynia fact sheet – Melbourne Sexual Health Centre (MSHC)

  https://www.mshc.org.au/sexual-health/sexual-health-fact-sheets/vulvodynia

  Vulvodynia or vulval pain is the term used to describe pain or discomfort at or around the vaginal opening. This pain happens without an obvious ongoing cause. […] The exact cause of vulvodynia and other chronic pain is not known. However, there is no single cause. […] Common triggers of vulval pain include: frequent skin inflammation, candida (thrush), even if itch and discharge are subtle, urinary infections, difficult to control dermatitis, very occasionally genital herpes may be involved. […] Persistent triggers causing inflammation contribute to chronic pain. These triggers of chronic pain include: other painful conditions of the pelvis or hip and back, genetic predisposition to pain, mood problems, poor sleep, chronic stress. […] There is a change in sensitivity of nerve endings and associated pelvic floor muscle overactivity. Recent research using brain scans shows that there are also changes in brain function associated with chronic pain and so the sensations of pain continue despite the absence of an obvious cause.

• #25 Vulvodynia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vulvodynia/symptoms-causes/syc-20353423

  Vulvodynia (vul-voe-DIN-e-uh) is a type of long-term pain or discomfort around the outer part of the female genitals, called the vulva. It lasts at least three months and has no clear cause. […] Experts don’t know what causes vulvodynia. Factors that might play a role include: […] Injury to or irritation of the nerves of the vulva. […] Past infections of the vagina. […] Painful swelling called inflammation that affects the vulva. […] Some genetic conditions. […] Allergies. […] Hormonal changes. […] Muscle spasm or weakness in the pelvic floor, which supports the uterus, bladder and bowel.

• #26 Vulvar Pain: Causes, Treatments, and More

  https://www.healthline.com/health/womens-health/vulvar-pain

  Vulvar nerve endings can become damaged during childbirth, sexual abuse, or sex without enough vaginal lubrication. Activities that put a lot of pressure on the vaginal region, such as bicycling or horseback riding, can also harm nerve endings and tissue. […] Women with vulvodynia may be 2 to 3 times more likely to have chronic pain conditions like fibromyalgia and irritable bowel syndrome. Both of those are inflammatory diseases, so this type of vulvodynia may be related to inflammation as well. […] Soaps, gels, and feminine deodorant products can cause an allergic reaction in the vulvar region in some women. That can lead to irritation, inflammation, and pain. […] One study found that women with chronic vulvar pain were more likely to have used hormone therapy than those who didn’t have pain. According to another study, there doesn’t appear to be a link between vulvar pain and the use of birth control, however.

• #27 Vestibulodynia | San Diego Sexual Medicine

  https://www.sdsm.info/female-issues/vestibulodynia

  Vulvodynia or vestibulodynia may be the result of many different causes. These may include inflammatory and infectious disease processes, neurologic conditions, genetic factors, stress factors, and hormone factors. As a result, one management strategy for all women with complaints of vulvar pain will likely not be successful. […] When specifically addressing provoked vestibulodyna (PVD), the most common causes are hormonal changes, tight (hypertonic) pelvic floor muscles, and an increased number of nerve endings in the mucosa of the vestibule. […] More research is needed to better understand the basis for disease in the vestibule that avoids the tissues of the vulva and the vagina. One theory is that vestibular tissue, in particular, tissue from the vestibular glands, has hormone receptors for testosterone and estradiol. In some women, the provoked vestibulodynia may be caused by a hormonal-mediated vestibulodynia where there is an absence of these hormone receptors. A common risk factor for hormonal-mediated provoked vestibulodynia is use of hormonal contraception, the birth control pill, the patch or the ring.

• #28 Vulvodynia: Persistent vulvar pain – Foundational Concepts

  https://www.foundationalconcepts.com/the-pelvic-chronicles-blog/vulvodynia-persistent-vulvar-pain/

  The pain in vulvodynia is not caused by a clinical disease. […] The cause of vulvodynia remains under study. To date, we dont have a solid answer. There are studies that have correlated genetic, immunological, hormonal, nerve and developmental factors as possible sources. […] Most likely it is a combination of factors: environmental, experiential and genetic/developmental that culminate toward a persistent pain state. […] Antibiotics do not directly cause genital pain, but long-term use can cause chronic yeast infections. This has been associated with vulvodynia. […] Hormonal contraceptives are another common medication used chronically by women. Studies suggest that oral contraceptives contribute to vulvodynia because they decrease testosterone levels, which are important for vulvar health.

• #29 Vulvodynia (vulvar pain): what is it, symptoms and treatment | Top Doctors

  https://www.topdoctors.co.uk/medical-dictionary/vulvodynia-vulvar-pain

  Vulvodynia is pain in the vulva which is persistent and unexplained. The vulva is the female genital area, and it includes the skin surrounding the vaginal opening. […] There is no clear cause for vulvodynia. However, factors that may contribute to vulvar pain include: Hormonal changes, Allergies to feminine hygiene products, Previous vaginal infections, Vulval nerves being injured or irritated, Inflammation, Muscle weakness in the pelvic floor, Some genetic conditions. […] Yes. When oestrogen levels fall, which is a symptom of the menopause and perimenopause, this can cause vaginal dryness which can lead to vulval pain. […] The impact of untreated vulvodynia can mean that you experience a lower quality of life. Vulvodynia can lead to a disturbed sleep and anxiety and depression around sex and body confidence.

• #30 Vulvar pain: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/320466

  Vulvar cancer occurs when abnormal cells grow in the tissues of the vulva. This can cause pain in the area. […] Vulvar intraepithelial neoplasia refers to cell changes that are not cancer but could become cancerous in the future. […] Conditions may cooccur with vulvodynia. These include fibromyalgia, interstitial cystitis, and irritable bowel syndrome (IBS). […] Trauma: Childbirth, sexual activity, and riding a bicycle or horse can damage the vulva and cause pain and discomfort. […] Hormonal changes occur with menopause and menstruation. These changes can cause sensitive tissues to become dry, swollen, or inflamed, leading to dry vagina, vulvar pain, pain during sex, and bladder issues.

• #31

  https://www.advocaremontgomerygyn.com/understanding-vulvodynia-a-comprehensive-guide-to-chronic-vulvar-pain

  Hormonal changes, particularly reduced estrogen levels, can thin the vulvar tissues, leading to increased sensitivity. This is commonly seen in post-menopausal women but can also occur in younger women due to birth control use or other hormonal changes. […] The pelvic floor muscles, which support the bladder, uterus, and rectum, can become tense or dysfunctional, leading to vulvar pain. Women with vulvodynia may experience spasms or tension in these muscles, exacerbating their symptoms. […] Research suggests that certain women may have a genetic predisposition to vulvodynia. Some studies have found links between vulvodynia and genetic markers related to pain sensitivity. Additionally, abnormalities in the immune response may cause some women to develop the condition after an injury or infection.

• #32 Vulvodynia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vulvodynia/symptoms-causes/syc-20353423

  Vulvodynia (vul-voe-DIN-e-uh) is a type of long-term pain or discomfort around the outer part of the female genitals, called the vulva. It lasts at least three months and has no clear cause. […] Experts don’t know what causes vulvodynia. Factors that might play a role include: […] Injury to or irritation of the nerves of the vulva. […] Past infections of the vagina. […] Painful swelling called inflammation that affects the vulva. […] Some genetic conditions. […] Allergies. […] Hormonal changes. […] Muscle spasm or weakness in the pelvic floor, which supports the uterus, bladder and bowel.

• #33 Vulvodynia: Causes, Symptoms, Management & Treatment

  https://my.clevelandclinic.org/health/diseases/17878-vulvodynia

  Vulvodynia is pain in your vulva that lasts longer than three months. Unlike vulvar pain that results from a condition, vulvodynia doesn’t have a clear cause. The pain can be so life-altering that it keeps you from engaging in activities you enjoy. […] Vulvodynia (pronounced vul-vo-DIN-ee-a) is chronic pain in your vulva, and or vagina or genitals, with no apparent cause. […] Vulvodynia is different. Vulvodynia is pain lasting three or more months that isn’t an obvious symptom of a specific condition. […] Researchers aren’t sure what causes vulvodynia, but there are many potential causes, including: Inflammation, Hormonal factors, Genetic (inherited) factors, Injury to your nerves (neuropathic problems), Long-term reactions to past vaginal infections, Weakened pelvic floor muscles or muscle spasms, Irritation from harsh products that touch your skin.

• #34 Vulval Pain | Pelvic Pain Support Network

  https://www.pelvicpain.org.uk/conditions/vulval-pain/

  Vulval pain may be related to several causes including infections such as candidosis or herpes, skin conditions (dermatosis) and occasionally precancerous or malignant conditions. […] Some data suggest that this pain may arise from persistent inflammatory damage to tissue. Some women may make more chemicals that increase or cause inflammation. […] Persistent infections may cause irritated vulvar tissue. […] The vestibule is the most frequently affected site of provoked vulvodynia (previously called vestibulitis). […] Most doctors, including some gynaecologists, may never have heard of vulvodynia. […] The management of vulval pain should follow the principles of chronic pain management. […] Those with vulvodynia, either spontaneous or provoked by touch, usually have pelvic floor muscle dysfunction.

• #35 The Ultimate Guide to Vulvar Pain & What to Do

  https://www.theoriginway.com/blog/the-ultimate-guide-to-vulvar-pain-vulvodynia-and-what-you-can-do-about-it

  Vulvodynia is commonly misdiagnosed and ignored in doctors offices, NSFW conversations with friends, and even search engine results. Research shows that while there’s no singular, identifiable cause of vulvodynia, activities like sex, injury, stress, and a tight, painful pelvic floor are often linked to the onset of this chronic pain condition that affects 8-10% of individuals with vaginal anatomy. […] According to Dr. Ashley Rawlins, PT, DPT at Origin, some common causes of vulvodynia can include: an allergic reaction, hormone imbalances, STIs, dermatologic conditions, and pelvic floor muscle dysfunction. Up to 90% of those with pelvic pain (including those with vulvodynia), have musculoskeletal pain and dysfunction, reports Rawlins. […] Not only can this common condition make everyday life and your favorite workout class more painful, but it’s also a leading cause of pain during sex for women who have not undergone menopause. In addition to the impact of sex, bike riding, injury, etc., other causes of vulvodynia can include pelvic floor dysfunction, anxiety, depression, early childhood trauma, and other chronic pain conditions.

• #36 Persistent Vulvar Pain | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/09/persistent-vulvar-pain

  Women with vulvodynia should be assessed for pelvic floor dysfunction. Biofeedback and physical therapy, including pelvic floor physical therapy, can be used to treat localized and generalized vulvar pain. […] An emerging treatment for vulvodynia is transcutaneous electrical nerve stimulation. […] When other nonsurgical management options have been tried and failed, and the pain is localized to the vestibule, vestibulectomy may be an effective treatment. […] Although optimal treatment remains unclear, consider an individualized, multidisciplinary approach to address all physical and emotional aspects possibly attributable to vulvodynia. […] Future research should aim at evaluating a multimodal approach in the treatment of vulvodynia, along with more research on the etiologies of vulvodynia.

• #37 Vulvodynia – Wikipedia

  https://en.wikipedia.org/wiki/Vulvodynia

  Vulvodynia is a chronic pain condition that affects the vulvar area and occurs without an identifiable cause. Symptoms typically include a feeling of burning or irritation. It has been established by the ISSVD that for the diagnosis to be made symptoms must last at least three months. […] The causes of vulvodynia are not fully understood, but there are many sub-types of vulvodynia with different causes, including an excess of nerve fibers, hormonal imbalances, inflammation, and muscular dysfunction. Some factors influencing the disease may include genetics, immunology, and possibly diet. […] Vulvodynia has many different sub-types and causes. The disease is highly idiopathic. Identifying the cause is important to determine the appropriate treatment. […] Pain confined to the vulval vestibule, known as vestibulodynia, has at least three known sub-types: neuroproliferation, hormonally-mediation, and inflammation. Neuroproliferation can be present from birth or acquired later in life. This type of vestibulodynia is known as neuroproliferative vestibulodynia. Hormonally-mediated vestibulodynia can be caused by hormonal medications like oral birth control. Inflammatory vestibulodynia can develop as part of an immune response.

• #38 Vulvar Pain: Causes, Treatments, and More

  https://www.healthline.com/health/womens-health/vulvar-pain

  Many women experience pain and discomfort in the vulva at some point in their lives. When the pain is persistent for more than three months and has no apparent cause, its called vulvodynia. […] Vulvar pain isn’t well understood. Vulvar pain is not contagious, nor is it spread through sex. Its also not a sign of cancer. […] Researchers have seen a link between vulvar pain and some conditions and factors in some women, such as the following. […] In one study, mice that were subjected to and treated for yeast infections three times were more likely to encounter vulvar pain than mice without yeast infection. The researchers theorized that the multiple yeast infections increased the production of nerve fibers in the mice. The increased nerve fibers resulted in more vulvar pain. […] Some women are born with genetic differences that cause cells to overreact to inflammation or hormones. That can cause pain when inflammation occurs in the vulvar region. Inflammation causes tissue to swell, fill with more blood, and feel hot and sore.

• #39 Vulvodynia: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/007699.htm

  Vulvodynia is a pain disorder of the vulva. This is the outside area of a woman’s genitals. Vulvodynia causes severe pain, burning, and stinging of the vulva. […] The exact cause of vulvodynia is unknown. Researchers are working to learn more about the condition. Causes may include: […] Irritation or injury to the nerves of the vulva, hormonal changes, overreaction in the cells of the vulva to infection or injury, extra nerve fibers in the vulva, weak pelvic floor muscles, allergies to certain chemicals, genetic factors that cause sensitivity or overreaction to infection or inflammation. […] Sexually transmitted infections (STIs) do not cause this condition. […] Vulvodynia is diagnosed when all other possible causes have been excluded. […] Vulvodynia is often a complicated condition. It may take weeks to months to achieve some pain relief. Treatment may not ease all symptoms. A combination of treatments and lifestyle changes may work best to help manage the symptoms of vulvodynia.

• #40 Vestibulodynia | San Diego Sexual Medicine

  https://www.sdsm.info/female-issues/vestibulodynia

  For women with secondary or acquired provoked vestibulodynia, researchers have shown the high density of pain nerves in the vestibule has occurred as the result of healing cells called mast cells excessively releasing a protein called nerve growth factor. […] Additional factors are theorized to play a role in why there is thought to be acquired provoked vestibulodynia. It is now observed that some women with acquired secondary provoked vestibulodynia have the existence of different DNA sequences in genes that express important enzymes. […] There are multiple other causes of provoked vulvodynia or provoked vestibulodynia including dermatologic conditions such as lichen sclerosus, and lichen planus, infectious reasons such as chronic infection from candida, tissue injury reasons from a fissure that forms in the posterior fourchette often related to poorly healing episiotomy repairs post-partum. […] Additionally, if a woman experiences decreased libido and/or lubrication after starting hormonal contraceptives, she should be aware that hormonal contraceptives may lead to provoked vestibulodynia.

• #41

  https://www.advocaremontgomerygyn.com/understanding-vulvodynia-a-comprehensive-guide-to-chronic-vulvar-pain

  Hormonal changes, particularly reduced estrogen levels, can thin the vulvar tissues, leading to increased sensitivity. This is commonly seen in post-menopausal women but can also occur in younger women due to birth control use or other hormonal changes. […] The pelvic floor muscles, which support the bladder, uterus, and rectum, can become tense or dysfunctional, leading to vulvar pain. Women with vulvodynia may experience spasms or tension in these muscles, exacerbating their symptoms. […] Research suggests that certain women may have a genetic predisposition to vulvodynia. Some studies have found links between vulvodynia and genetic markers related to pain sensitivity. Additionally, abnormalities in the immune response may cause some women to develop the condition after an injury or infection.

• #42 Vulvodynia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vulvodynia/symptoms-causes/syc-20353423

  Vulvodynia (vul-voe-DIN-e-uh) is a type of long-term pain or discomfort around the outer part of the female genitals, called the vulva. It lasts at least three months and has no clear cause. […] Experts don’t know what causes vulvodynia. Factors that might play a role include: […] Injury to or irritation of the nerves of the vulva. […] Past infections of the vagina. […] Painful swelling called inflammation that affects the vulva. […] Some genetic conditions. […] Allergies. […] Hormonal changes. […] Muscle spasm or weakness in the pelvic floor, which supports the uterus, bladder and bowel.

• #43 Vulvodynia Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/vulvodynia

  Vulvodynia is a pain disorder of the vulva. This is the outside area of a woman’s genitals. Vulvodynia causes severe pain, burning, and stinging of the vulva. […] The exact cause of vulvodynia is unknown. Researchers are working to learn more about the condition. Causes may include: […] Irritation or injury to the nerves of the vulva, hormonal changes, overreaction in the cells of the vulva to infection or injury, extra nerve fibers in the vulva, weak pelvic floor muscles, allergies to certain chemicals, genetic factors that cause sensitivity or overreaction to infection or inflammation. […] Sexually transmitted infections (STIs) do not cause this condition. […] Vulvodynia is diagnosed when all other possible causes have been excluded. […] Some women with localized vulvodynia may need surgery to relieve pain. The surgery removes the affected skin and tissues around the vaginal opening. Surgery is done only if all the other treatments fail.

• #44 Vulvar Pain (Vulvodynia): Symptoms, Causes and Remedies | Carreras Medical Center

  https://www.toplinemd.com/carreras-medical-center/vulvar-pain-vulvodynia-symptoms-causes-and-remedies/

  Allergies: Some females can experience inflammation, pain, and irritation in the vulvar region due to harsh feminine deodorants, gels, and soaps. These products may lead to an allergic reaction. […] Sexual or physical trauma: Pain in the vaginal area could also be caused by sexual abuse, childbirth, or sexual intercourse without adequate vaginal lubrication. Other activities that can put excessive pressure on the vaginal area, such as horseback riding, can also cause harm to this region. If your vagina is throbbing during these activities, stop immediately and get help.

• #45 Vulvodynia FAQ’s

  https://www.contemporaryobgyn.net/view/vulvodynia-faqs

  Autoimmune problems occur when the body fails to differentiate between its own tissue and the pathogens it needs to attack. […] High white-blood-cell count (WBC) signals some sort of infection in your body. The infection may be either bacterial or viral (herpes, HPV). […] This is normally a condition in which large, painful red nodules appear on the legs (or sometimes other areas). The condition is thought to result from an abnormally activated immune system. […] Chronic activation of your body’s „fight or flight” system may result in tense or unstable pelvic muscles, reduce the volume of blood flowing to the genitals, and over stimulate the nerve pathways, leading to pain. […] Fibromyalgia is a systemic but non-inflammatory and non-degenerative disease of unknown etiology. […] A number of women suffer from some hormone disruption — either irregular periods, endometriosis, ovarian problems, or the mis-named polycystic ovarian syndrome, which is actually related to insulin resistance.

• #46 Vulval Pain | Pelvic Pain Support Network

  https://www.pelvicpain.org.uk/conditions/vulval-pain/

  It is sensible to avoid irritants in everyday products as far as possible. […] Very low doses of tricyclic antidepressants eg. amitriptyline or nortriptyline may be used for unprovoked vulvodynia, the doses used for pain are far lower than the doses used for depression. […] Surgical removal of the tissue around the opening of the vagina (vestibulectomy) is not generally beneficial in women with provoked vulvodynia.

• #47 Conditions – The Centers for Vulvovaginal Disorders

  https://vulvodynia.com/conditions/vulvar-vestibulitis

  „Neuronal proliferation” (NP) A condition in which the density of nerve ending is increased in the vestibular mucosa. […] „Vaginitis” Sometimes there is inflammation so severe in the vagina that the inflammatory white blood cells pour out of the vagina and coat the vestibule and cause a secondary vestibulitis. […] „Irritant or Allergic Contact Vestibulitis.” Unfortunately, women expose their vulvas to dozens of different chemicals almost every day. […] It is imperative that a woman with vestibulitis have a thorough evaluation by health care provider familiar with all the causes of vestibular pain.

• #48 Etiology, diagnosis, and clinical management of vulvodynia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4014358/

  Women may identify trauma as precipitating their pain. […] Chronic local inflammation may result in an increase in: neurotransmitters and immune-mediated factors; proliferation of unmyelinated nerve fibers; chronic stimulation of afferent primary c fibers; and chronic stimulation of the dorsal horn cells in the spinal cord. […] Histologic evidence of local changes to the vestibular skin in women with PVD includes chronic inflammatory infiltration, including increased mast cells and plasma cells, and increased nerve fibers. […] Thus, the acute nociceptive pain may result first in peripheral sensitization and ultimately central sensitization, ie, neuropathic pain. […] Women with vulvodynia have been found to have generalized hypersensitivity, a decreased pain threshold in the vulvar area as well as other areas of the body, and enhanced pain processing.

• #49 Vulvar Pain: Causes, Treatments, and More

  https://www.healthline.com/health/womens-health/vulvar-pain

  Vulvar nerve endings can become damaged during childbirth, sexual abuse, or sex without enough vaginal lubrication. Activities that put a lot of pressure on the vaginal region, such as bicycling or horseback riding, can also harm nerve endings and tissue. […] Women with vulvodynia may be 2 to 3 times more likely to have chronic pain conditions like fibromyalgia and irritable bowel syndrome. Both of those are inflammatory diseases, so this type of vulvodynia may be related to inflammation as well. […] Soaps, gels, and feminine deodorant products can cause an allergic reaction in the vulvar region in some women. That can lead to irritation, inflammation, and pain. […] One study found that women with chronic vulvar pain were more likely to have used hormone therapy than those who didn’t have pain. According to another study, there doesn’t appear to be a link between vulvar pain and the use of birth control, however.

• #50 Vulvar Pain (Vulvodynia): Symptoms, Causes and Remedies | Carreras Medical Center

  https://www.toplinemd.com/carreras-medical-center/vulvar-pain-vulvodynia-symptoms-causes-and-remedies/

  Allergies: Some females can experience inflammation, pain, and irritation in the vulvar region due to harsh feminine deodorants, gels, and soaps. These products may lead to an allergic reaction. […] Sexual or physical trauma: Pain in the vaginal area could also be caused by sexual abuse, childbirth, or sexual intercourse without adequate vaginal lubrication. Other activities that can put excessive pressure on the vaginal area, such as horseback riding, can also cause harm to this region. If your vagina is throbbing during these activities, stop immediately and get help.

• #51 Vulval pain | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/vulva-vagina/vulval-pain

  Vulvodynia is the medical term for chronic pain or discomfort in the vulva that lasts for at least three months. […] Vulvodynia pain can be caused by pressure or touch (provoked), or it can happen for no reason (unprovoked). […] We dont know what causes different types of vulvodynia. Some studies suggest vulvodynia is associated with: chronic yeast infections (e.g. thrush), injury or tissue damage (e.g. childbirth, laser treatment, surgery, sexual abuse), skin conditions (e.g. allergic reactions to soaps and scented toiletry products). […] Pudendal neuralgia may be caused by one or more factors, including: repeated minor damage from sitting, cycling, or horse riding for long periods of time, repetitive heavy lifting and excessive exercise, straining when trying to poo due to chronic constipation, nerve, muscle or soft tissue trauma due to childbirth, surgery (e.g. gynaecological). […] Pudendal neuralgia can cause ongoing pain and discomfort and interfere with daily activities. It can also lead to: high levels of stress, anxiety, depression, sexual problems, including painful sex, problems related to weeing and pooing.

• #52 Vulvar Pain Treatment – WHRIA

  https://www.whria.com.au/for-patients/pelvic-pain/vulvar-pain/

  Common causes for vulvar pain include: Dermatological (skin) conditions, Infection, Trauma, Pudendal nerve entrapment (this is the nerve supplying the vulval region), Neuropathic (nerve related) pain. […] However, in many cases the problem may be multifactorial or the specific cause may be difficult to identify. […] What causes Vestibulodynia? In some cases we are able to identify a trigger. These may include: Bad thrush infection, Dermatological disorder, Trauma to the area, Childbirth, Surgery, Painful episode of sexual intercourse. […] In many cases there is no identifiable trigger and the symptoms develop for no obvious reason. […] What causes Generalised Unprovoked Vulvodynia? The cause is unknown. Some theories suggest that the nerve system supplying the vulvar area is abnormal, resulting in increased pain messages being sent or felt by the brain. There may be a history of problems with the pelvic musculoskeletal system, previous trauma to the area or pudendal nerve entrapment.

• #53 Vulvodynia – Wikipedia

  https://en.wikipedia.org/wiki/Vulvodynia

  Other possible causes include Sjgren syndrome, the symptoms of which include chronic vaginal dryness. Others include genetic predisposition to inflammation, allergy or other sensitivity (for example: oxalates in the urine), an autoimmune disorder similar to lupus erythematosus or to eczema or to lichen sclerosus, infection (e.g., yeast infections, bacterial vaginosis, HPV, HSV), injury, and neuropathy including an increased number of nerve endings in the vaginal area. Some cases seem to be negative outcomes of genital surgery, such as a labioplasty. […] Pelvic floor dysfunction may be the underlying cause of some women’s pain. […] Many co-morbidities are commonly associated with vulvodynia, including fibromyalgia, irritable bowel syndrome, interstitial cystitis, pelvic floor dysfunction, endometriosis, depression and anxiety disorders.

• #54 Vulvodynia | Doctor

  https://patient.info/doctor/vulvodynia-pro

  Vulvodynia has many possible treatments; however, very few controlled trials have been performed to verify efficacy of these treatments. Aetiology is not understood and is likely to be multifactorial. There are a number of theories which include: A trigger causing inflammation or injury, causing stimulation of pain receptors, and receptor/nerve damage. Triggers possibly involved could be infections, skin conditions, allergies, trauma or hormonal factors. General urogenital hypersensitivity. Disordered central pain processing. Somatoform pain disorder. […] Associations with other chronic pain conditions are common, with one study finding 45% of women with vulvodynia also having one of the following: Fibromyalgia, Irritable bowel syndrome, Chronic fatigue syndrome, Interstitial cystitis, Endometriosis. A history of recurrent vulvovaginal candidiasis is commonly associated. Women with a past history of anxiety and/or depression are more likely to get vulvodynia. […] The natural history of this disorder is not clear. There is a high placebo effect in trials, suggesting high rates of spontaneous improvement in symptoms. Many treatment options have shown good success rates. However, improvement may take time and a combination of therapies.

• #55 Vulvar Pain: Causes, Treatments, and More

  https://www.healthline.com/health/womens-health/vulvar-pain

  Vulvar nerve endings can become damaged during childbirth, sexual abuse, or sex without enough vaginal lubrication. Activities that put a lot of pressure on the vaginal region, such as bicycling or horseback riding, can also harm nerve endings and tissue. […] Women with vulvodynia may be 2 to 3 times more likely to have chronic pain conditions like fibromyalgia and irritable bowel syndrome. Both of those are inflammatory diseases, so this type of vulvodynia may be related to inflammation as well. […] Soaps, gels, and feminine deodorant products can cause an allergic reaction in the vulvar region in some women. That can lead to irritation, inflammation, and pain. […] One study found that women with chronic vulvar pain were more likely to have used hormone therapy than those who didn’t have pain. According to another study, there doesn’t appear to be a link between vulvar pain and the use of birth control, however.

• #56 Etiology, diagnosis, and clinical management of vulvodynia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4014358/

  Central sensitization may in fact precede the peripheral sensitization. […] These etiologic theories position vulvodynia as a neuropathic disorder. However, some authors have suggested that vulvodynia is a somatoform or functional pain disorder, ie, a type of somatic pain syndrome similar to fibromyalgia, interstitial cystitis, and/or irritable bowel syndrome. […] It is often impossible for a woman with vulvodynia and/or her clinician to confidently identify a single biological cause for her pain. […] The chronicity of the pain predictably gives rise to significant problems concerning a womans psychological, sexual, and pelvic floor health. […] However, the diagnosis and treatment of women with vulvodynia involves recognition and assessment of all the factors influencing her experience of pain.

• #57

  https://www.yourdaye.com/en-us/vitals/womens-health/vulvodynia-why-does-my-vulva-hurt/?srsltid=AfmBOooLc9nYKRh2tZoAEklxplC0hkKPfkU0zWJwsdh4XeHfNJ2IvOmm

  Its no secret that your vulva is a fairly sensitive area of your body, so its common to experience vulvar pain or discomfort at some point in your life. […] Vulvar pain can be a temporary symptom of infection or an inflammatory condition. Sometimes, however, it can be a chronic idiopathic condition which means it shows up spontaneously and for no known reason. […] However, when vulvar pain is idiopathic its classified as vulvodynia. […] Vulvodynia is a chronic, often disabling condition that causes pain and discomfort of the vulva and can make everyday activities like sex and using tampons incredibly painful. […] Women with vulvodynia may also be 2 to 3 times more likely to have other chronic pain conditions, such as fibromyalgia and IBS, suggesting a link between vulvodynia and inflammatory disease.

• #58 What is Vulvodynia and What Causes It?

  https://cherokeewomenshealth.com/2016/09/what-is-vulvodynia-and-what-causes-it/

  Vulvodynia is persistent, inexplicable pain anywhere in the vulva. […] Though it is not known exactly what causes Vulvodynia, doctors speculate that there may be several triggers: Allergies or sensitive skin that can be easily irritated, hormonal changes or hormonal contraception, injuries to the vulvar areas surrounding nerves, sexual abuse, a predisposition to yeast infections, pelvic floor dysfunction, past history of anxiety and/or depression, muscle spasms, frequent antibiotic use. […] In most cases, however, there is no absolute known cause, and the reasons for Vulvodynia remain a mystery. […] Vulvodynia has also been associated with several other chronic pain-related conditions, meaning that there is a higher likelihood of vulvodynia if a woman has any of the following: Interstitial cystitis, fibromyalgia, irritable bowel syndrome, endometriosis, chronic fatigue syndrome.

• #59 Vulvodynia | Doctor

  https://patient.info/doctor/vulvodynia-pro

  Vulvodynia has many possible treatments; however, very few controlled trials have been performed to verify efficacy of these treatments. Aetiology is not understood and is likely to be multifactorial. There are a number of theories which include: A trigger causing inflammation or injury, causing stimulation of pain receptors, and receptor/nerve damage. Triggers possibly involved could be infections, skin conditions, allergies, trauma or hormonal factors. General urogenital hypersensitivity. Disordered central pain processing. Somatoform pain disorder. […] Associations with other chronic pain conditions are common, with one study finding 45% of women with vulvodynia also having one of the following: Fibromyalgia, Irritable bowel syndrome, Chronic fatigue syndrome, Interstitial cystitis, Endometriosis. A history of recurrent vulvovaginal candidiasis is commonly associated. Women with a past history of anxiety and/or depression are more likely to get vulvodynia. […] The natural history of this disorder is not clear. There is a high placebo effect in trials, suggesting high rates of spontaneous improvement in symptoms. Many treatment options have shown good success rates. However, improvement may take time and a combination of therapies.

• #60 Etiology, diagnosis, and clinical management of vulvodynia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4014358/

  Central sensitization may in fact precede the peripheral sensitization. […] These etiologic theories position vulvodynia as a neuropathic disorder. However, some authors have suggested that vulvodynia is a somatoform or functional pain disorder, ie, a type of somatic pain syndrome similar to fibromyalgia, interstitial cystitis, and/or irritable bowel syndrome. […] It is often impossible for a woman with vulvodynia and/or her clinician to confidently identify a single biological cause for her pain. […] The chronicity of the pain predictably gives rise to significant problems concerning a womans psychological, sexual, and pelvic floor health. […] However, the diagnosis and treatment of women with vulvodynia involves recognition and assessment of all the factors influencing her experience of pain.

• #61 What is vulvodynia?

  https://www.bbc.com/future/article/20180725-the-health-condition-vulvodynia-is-painful-and-misunderstood

  One recent theory has been that vulvodynia’s symptoms may stem not from the affected part of the body, but in the brain as is the case with other chronic pain disorders. […] There are ways to cope with the pain and treat symptoms of the condition, says Stoehr. But it may take time to find the proper therapy for each individual. This isn’t the common cold, she said. Rather it often requires symptom management for the rest of the patient’s life.

• #62 Vulvodynia: Causes, Symptoms, Management & Treatment

  https://my.clevelandclinic.org/health/diseases/17878-vulvodynia

  Data suggests that people with vulvodynia are more likely to have higher levels of stress, histories of abuse and certain behavioral health conditions, including: Anxiety, Depression, Post-traumatic stress disorder (PTSD). […] Unfortunately, vulvodynia isn’t preventable. […] There isn’t enough evidence to predict when (or if) your vulvodynia will ease or resolve on its own.

• #63 Vulvodynia: Causes, Symptoms, and Treatments

  https://www.webmd.com/women/vulvodynia

  Vulvodynia is a chronic pain condition affecting the vulva (outer female genitals). It usually lasts more than three months, and there’s no known cause. […] Doctors don’t know the cause of most forms of vulvodynia. And there’s no proof that infections, such as sexually transmitted diseases(STDs), lead to vulvodynia. […] Researchers are trying to find the causes. They may include: Nerve injury or irritation, Abnormal response in vulvar cells to an infection or trauma, Genetic factors that cause the vulva to react poorly to chronic inflammation, Hypersensitivity to yeast infections, Muscle spasms, Allergies or irritation to chemicals or other substances, Hormonal changes, A history of sexual abuse, Frequent antibiotic use. […] Possible risk factors for vulvodynia include: Anxiety, Depression, A history of abuse, Posttraumatic stress disorder (PTSD).

• #64 Vulvodynia FAQ’s

  https://www.contemporaryobgyn.net/view/vulvodynia-faqs

  Autoimmune problems occur when the body fails to differentiate between its own tissue and the pathogens it needs to attack. […] High white-blood-cell count (WBC) signals some sort of infection in your body. The infection may be either bacterial or viral (herpes, HPV). […] This is normally a condition in which large, painful red nodules appear on the legs (or sometimes other areas). The condition is thought to result from an abnormally activated immune system. […] Chronic activation of your body’s „fight or flight” system may result in tense or unstable pelvic muscles, reduce the volume of blood flowing to the genitals, and over stimulate the nerve pathways, leading to pain. […] Fibromyalgia is a systemic but non-inflammatory and non-degenerative disease of unknown etiology. […] A number of women suffer from some hormone disruption — either irregular periods, endometriosis, ovarian problems, or the mis-named polycystic ovarian syndrome, which is actually related to insulin resistance.

• #65 Is vulvodynia causing your vulva pain?

  https://flo.health/health-articles/diseases/vulvodynia

  Vulvodynia can often be triggered by touch, such as during sexual intercourse, inserting a tampon, sports like riding a bicycle, wearing tight clothing, or sitting for long periods of time. It can also be triggered by psychological factors, including trauma or stress. […] Though research is limited, one study found that women who were diagnosed with an anxiety disorder have a higher risk of developing vulvodynia. The link between vulvodynia and mental health works both ways as the study also found that vulvodynia can trigger anxiety in sufferers. Further research found that people with vulvodynia are more likely to experience depression and anxiety.

• #66 Etiology, diagnosis, and clinical management of vulvodynia | IJWH

  https://www.dovepress.com/etiology-diagnosis-and-clinical-management-of-vulvodynia-peer-reviewed-fulltext-article-IJWH

  Chronic vulvar pain or discomfort for which no obvious etiology can be found, ie, vulvodynia, can affect up to 16% of women. […] The etiology is multifactorial and may involve local injury or inflammation, and peripheral and or central sensitization of the nervous system. […] Women with vulvodynia are often very distressed about not being able to identify a cause for their pain. The etiology of vulvodynia is uncertain and likely multifactorial. There is debate about whether the pain is primarily caused by a local insult or injury, or a maladaptive peripheral and/or maladaptive central pain processing mechanism. […] At a local level, there may be an initial trigger that causes inflammation and/or injury affecting the vulva. This results in repetitive stimulation of pain receptors and ultimately receptor or nerve damage (nociceptive pain).

• #67 Etiology, diagnosis, and clinical management of vulvodynia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4014358/

  Chronic vulvar pain or discomfort for which no obvious etiology can be found, ie, vulvodynia, can affect up to 16% of women. […] The etiology is multifactorial and may involve local injury or inflammation, and peripheral and or central sensitization of the nervous system. […] The etiology of vulvodynia is uncertain and likely multifactorial. There is debate about whether the pain is primarily caused by a local insult or injury, or a maladaptive peripheral and/or maladaptive central pain processing mechanism. […] At a local level, there may be an initial trigger that causes inflammation and/or injury affecting the vulva. This results in repetitive stimulation of pain receptors and ultimately receptor or nerve damage (nociceptive pain). […] Allergic contact dermatitis and yeast or other urogenital infections have all been proposed as causes for inflammation.

• #68 Etiology, diagnosis, and clinical management of vulvodynia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4014358/

  Chronic vulvar pain or discomfort for which no obvious etiology can be found, ie, vulvodynia, can affect up to 16% of women. […] The etiology is multifactorial and may involve local injury or inflammation, and peripheral and or central sensitization of the nervous system. […] The etiology of vulvodynia is uncertain and likely multifactorial. There is debate about whether the pain is primarily caused by a local insult or injury, or a maladaptive peripheral and/or maladaptive central pain processing mechanism. […] At a local level, there may be an initial trigger that causes inflammation and/or injury affecting the vulva. This results in repetitive stimulation of pain receptors and ultimately receptor or nerve damage (nociceptive pain). […] Allergic contact dermatitis and yeast or other urogenital infections have all been proposed as causes for inflammation.

• #69 Etiology, diagnosis, and clinical management of vulvodynia | IJWH

  https://www.dovepress.com/etiology-diagnosis-and-clinical-management-of-vulvodynia-peer-reviewed-fulltext-article-IJWH

  Allergic contact dermatitis and yeast or other urogenital infections have all been proposed as causes for inflammation. […] Other women report the onset of pain to be associated with a hormonal trigger (eg, starting the birth control pill, postpartum amenorrhea, or perimenopause). […] Chronic local inflammation may result in an increase in: neurotransmitters and immune-mediated factors; proliferation of unmyelinated nerve fibers; chronic stimulation of afferent primary c fibers; and chronic stimulation of the dorsal horn cells in the spinal cord. […] Histologic evidence of local changes to the vestibular skin in women with PVD includes chronic inflammatory infiltration, including increased mast cells and plasma cells, and increased nerve fibers. […] Thus, the acute nociceptive pain may result first in peripheral sensitization and ultimately central sensitization, ie, neuropathic pain. This sensitization prolongs the symptoms long after the original tissue injury.

• #70 Etiology, diagnosis, and clinical management of vulvodynia | IJWH

  https://www.dovepress.com/etiology-diagnosis-and-clinical-management-of-vulvodynia-peer-reviewed-fulltext-article-IJWH

  Allergic contact dermatitis and yeast or other urogenital infections have all been proposed as causes for inflammation. […] Other women report the onset of pain to be associated with a hormonal trigger (eg, starting the birth control pill, postpartum amenorrhea, or perimenopause). […] Chronic local inflammation may result in an increase in: neurotransmitters and immune-mediated factors; proliferation of unmyelinated nerve fibers; chronic stimulation of afferent primary c fibers; and chronic stimulation of the dorsal horn cells in the spinal cord. […] Histologic evidence of local changes to the vestibular skin in women with PVD includes chronic inflammatory infiltration, including increased mast cells and plasma cells, and increased nerve fibers. […] Thus, the acute nociceptive pain may result first in peripheral sensitization and ultimately central sensitization, ie, neuropathic pain. This sensitization prolongs the symptoms long after the original tissue injury.

• #71 Etiology, diagnosis, and clinical management of vulvodynia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4014358/

  Central sensitization may in fact precede the peripheral sensitization. […] These etiologic theories position vulvodynia as a neuropathic disorder. However, some authors have suggested that vulvodynia is a somatoform or functional pain disorder, ie, a type of somatic pain syndrome similar to fibromyalgia, interstitial cystitis, and/or irritable bowel syndrome. […] It is often impossible for a woman with vulvodynia and/or her clinician to confidently identify a single biological cause for her pain. […] The chronicity of the pain predictably gives rise to significant problems concerning a womans psychological, sexual, and pelvic floor health. […] However, the diagnosis and treatment of women with vulvodynia involves recognition and assessment of all the factors influencing her experience of pain.

• #72 Etiology, diagnosis, and clinical management of vulvodynia | IJWH

  https://www.dovepress.com/etiology-diagnosis-and-clinical-management-of-vulvodynia-peer-reviewed-fulltext-article-IJWH

  Conversely, the initial trigger may not involve peripheral sensitization of the vulva, but rather begin with generalized urogenital, pelvic, and/or central nervous sensitivity. […] Women with vulvodynia have been found to have generalized hypersensitivity, a decreased pain threshold in the vulvar area as well as other areas of the body, and enhanced pain processing. […] Central sensitization may in fact precede the peripheral sensitization. […] These etiologic theories position vulvodynia as a neuropathic disorder. However, some authors have suggested that vulvodynia is a somatoform or functional pain disorder, ie, a type of somatic pain syndrome similar to fibromyalgia, interstitial cystitis, and/or irritable bowel syndrome. […] It is often impossible for a woman with vulvodynia and/or her clinician to confidently identify a single biological cause for her pain.

• #73 Etiology, diagnosis, and clinical management of vulvodynia | IJWH

  https://www.dovepress.com/etiology-diagnosis-and-clinical-management-of-vulvodynia-peer-reviewed-fulltext-article-IJWH

  Conversely, the initial trigger may not involve peripheral sensitization of the vulva, but rather begin with generalized urogenital, pelvic, and/or central nervous sensitivity. […] Women with vulvodynia have been found to have generalized hypersensitivity, a decreased pain threshold in the vulvar area as well as other areas of the body, and enhanced pain processing. […] Central sensitization may in fact precede the peripheral sensitization. […] These etiologic theories position vulvodynia as a neuropathic disorder. However, some authors have suggested that vulvodynia is a somatoform or functional pain disorder, ie, a type of somatic pain syndrome similar to fibromyalgia, interstitial cystitis, and/or irritable bowel syndrome. […] It is often impossible for a woman with vulvodynia and/or her clinician to confidently identify a single biological cause for her pain.

• #74 Etiology, diagnosis, and clinical management of vulvodynia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4014358/

  Central sensitization may in fact precede the peripheral sensitization. […] These etiologic theories position vulvodynia as a neuropathic disorder. However, some authors have suggested that vulvodynia is a somatoform or functional pain disorder, ie, a type of somatic pain syndrome similar to fibromyalgia, interstitial cystitis, and/or irritable bowel syndrome. […] It is often impossible for a woman with vulvodynia and/or her clinician to confidently identify a single biological cause for her pain. […] The chronicity of the pain predictably gives rise to significant problems concerning a womans psychological, sexual, and pelvic floor health. […] However, the diagnosis and treatment of women with vulvodynia involves recognition and assessment of all the factors influencing her experience of pain.

• #75

  https://www.advocaremontgomerygyn.com/understanding-vulvodynia-a-comprehensive-guide-to-chronic-vulvar-pain

  In some cases, women with vulvodynia may have a condition known as central sensitization, where the nervous system becomes hyperactive, making even minor sensations feel painful. This theory suggests that the brain and spinal cord amplify pain signals, turning ordinary sensations like touch or pressure into chronic pain.

• #76 What is vulvodynia?

  https://www.bbc.com/future/article/20180725-the-health-condition-vulvodynia-is-painful-and-misunderstood

  One recent theory has been that vulvodynia’s symptoms may stem not from the affected part of the body, but in the brain as is the case with other chronic pain disorders. […] There are ways to cope with the pain and treat symptoms of the condition, says Stoehr. But it may take time to find the proper therapy for each individual. This isn’t the common cold, she said. Rather it often requires symptom management for the rest of the patient’s life.

• #77 Persistent Vulvar Pain | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/09/persistent-vulvar-pain

  Vulvar pain can be caused by a specific disorder or it can be idiopathic. Idiopathic vulvar pain is classified as vulvodynia. […] The classification of vulvodynia is based on the site of the pain; whether it is generalized, localized, or mixed; whether it is provoked, spontaneous, or mixed; whether the onset is primary or secondary; and the temporal pattern (whether the pain is intermittent, persistent, constant, immediate, or delayed). […] Vulvodynia is a diagnosis of exclusion. Thus, excluding other treatable causes before assigning this diagnosis is imperative. […] A musculoskeletal evaluation would help rule out musculoskeletal factors associated with vulvodynia, such as pelvic muscle overactivity and myofascial or other biomechanical disorders. […] Medications used to treat vulvar pain include topical, oral, and intralesional medicinal substances, as well as pudendal nerve blocks and botulinum toxin. Tricyclic antidepressants and anticonvulsants also can be used for vulvodynia pain control.

• #78 Vulvodynia – Wikipedia

  https://en.wikipedia.org/wiki/Vulvodynia

  Vulvodynia is a chronic pain condition that affects the vulvar area and occurs without an identifiable cause. Symptoms typically include a feeling of burning or irritation. It has been established by the ISSVD that for the diagnosis to be made symptoms must last at least three months. […] The causes of vulvodynia are not fully understood, but there are many sub-types of vulvodynia with different causes, including an excess of nerve fibers, hormonal imbalances, inflammation, and muscular dysfunction. Some factors influencing the disease may include genetics, immunology, and possibly diet. […] Vulvodynia has many different sub-types and causes. The disease is highly idiopathic. Identifying the cause is important to determine the appropriate treatment. […] Pain confined to the vulval vestibule, known as vestibulodynia, has at least three known sub-types: neuroproliferation, hormonally-mediation, and inflammation. Neuroproliferation can be present from birth or acquired later in life. This type of vestibulodynia is known as neuroproliferative vestibulodynia. Hormonally-mediated vestibulodynia can be caused by hormonal medications like oral birth control. Inflammatory vestibulodynia can develop as part of an immune response.

• #79 What is Vulvodynia?

  https://www.nva.org/what-is-vulvodynia/

  Vulvodynia, simply put, is chronic vulvar pain without an identifiable cause. […] The majority of women with localized vulvodynia have Provoked Vestibulodynia (PVD), in which pain occurs during or after pressure is applied to the vestibule, e.g., with: sexual intercourse, tampon insertion, a gynecologic examination, prolonged sitting, and/or wearing fitted pants. […] For women with generalized vulvodynia (GV), pain occurs spontaneously and is relatively constant, but there can be some periods of symptom relief.

• #80 Vulvodynia – Wikipedia

  https://en.wikipedia.org/wiki/Vulvodynia

  Vulvodynia is a chronic pain condition that affects the vulvar area and occurs without an identifiable cause. Symptoms typically include a feeling of burning or irritation. It has been established by the ISSVD that for the diagnosis to be made symptoms must last at least three months. […] The causes of vulvodynia are not fully understood, but there are many sub-types of vulvodynia with different causes, including an excess of nerve fibers, hormonal imbalances, inflammation, and muscular dysfunction. Some factors influencing the disease may include genetics, immunology, and possibly diet. […] Vulvodynia has many different sub-types and causes. The disease is highly idiopathic. Identifying the cause is important to determine the appropriate treatment. […] Pain confined to the vulval vestibule, known as vestibulodynia, has at least three known sub-types: neuroproliferation, hormonally-mediation, and inflammation. Neuroproliferation can be present from birth or acquired later in life. This type of vestibulodynia is known as neuroproliferative vestibulodynia. Hormonally-mediated vestibulodynia can be caused by hormonal medications like oral birth control. Inflammatory vestibulodynia can develop as part of an immune response.

• #81 Vestibulodynia | San Diego Sexual Medicine

  https://www.sdsm.info/female-issues/vestibulodynia

  Other research to understand the basis for disease in the vestibule that avoids the tissues of the vulva and the vagina is based on a non-hormonal theory. Multiple investigations have observed a proliferation or growth of pain nerves, called c-afferent nociceptors in the skin layer of the vestibule. In some patients with provoked vestibulodynia, there has been found to exist a 10-fold increase in the density of pain fiber nerve endings in the vestibule skin lining compared to women who did not have provoked vestibulodynia. […] For women with primary or lifetime provoked vestibulodynia, it is felt by some experts that the high density of pain nerves in the vestibule has occurred as the result of a congenital accumulation of nerve fibers, called congenital neuronal hyperplasia, in the tissue derived from the urethral/bladder region or the primitive urogenital sinus.

• #82 Vestibulodynia | San Diego Sexual Medicine

  https://www.sdsm.info/female-issues/vestibulodynia

  Vulvodynia or vestibulodynia may be the result of many different causes. These may include inflammatory and infectious disease processes, neurologic conditions, genetic factors, stress factors, and hormone factors. As a result, one management strategy for all women with complaints of vulvar pain will likely not be successful. […] When specifically addressing provoked vestibulodyna (PVD), the most common causes are hormonal changes, tight (hypertonic) pelvic floor muscles, and an increased number of nerve endings in the mucosa of the vestibule. […] More research is needed to better understand the basis for disease in the vestibule that avoids the tissues of the vulva and the vagina. One theory is that vestibular tissue, in particular, tissue from the vestibular glands, has hormone receptors for testosterone and estradiol. In some women, the provoked vestibulodynia may be caused by a hormonal-mediated vestibulodynia where there is an absence of these hormone receptors. A common risk factor for hormonal-mediated provoked vestibulodynia is use of hormonal contraception, the birth control pill, the patch or the ring.

• #83 Vulvodynia – Wikipedia

  https://en.wikipedia.org/wiki/Vulvodynia

  Vulvodynia is a chronic pain condition that affects the vulvar area and occurs without an identifiable cause. Symptoms typically include a feeling of burning or irritation. It has been established by the ISSVD that for the diagnosis to be made symptoms must last at least three months. […] The causes of vulvodynia are not fully understood, but there are many sub-types of vulvodynia with different causes, including an excess of nerve fibers, hormonal imbalances, inflammation, and muscular dysfunction. Some factors influencing the disease may include genetics, immunology, and possibly diet. […] Vulvodynia has many different sub-types and causes. The disease is highly idiopathic. Identifying the cause is important to determine the appropriate treatment. […] Pain confined to the vulval vestibule, known as vestibulodynia, has at least three known sub-types: neuroproliferation, hormonally-mediation, and inflammation. Neuroproliferation can be present from birth or acquired later in life. This type of vestibulodynia is known as neuroproliferative vestibulodynia. Hormonally-mediated vestibulodynia can be caused by hormonal medications like oral birth control. Inflammatory vestibulodynia can develop as part of an immune response.

• #84 Persistent Vulvar Pain | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/09/persistent-vulvar-pain

  Vulvar pain can be caused by a specific disorder or it can be idiopathic. Idiopathic vulvar pain is classified as vulvodynia. […] The classification of vulvodynia is based on the site of the pain; whether it is generalized, localized, or mixed; whether it is provoked, spontaneous, or mixed; whether the onset is primary or secondary; and the temporal pattern (whether the pain is intermittent, persistent, constant, immediate, or delayed). […] Vulvodynia is a diagnosis of exclusion. Thus, excluding other treatable causes before assigning this diagnosis is imperative. […] A musculoskeletal evaluation would help rule out musculoskeletal factors associated with vulvodynia, such as pelvic muscle overactivity and myofascial or other biomechanical disorders. […] Medications used to treat vulvar pain include topical, oral, and intralesional medicinal substances, as well as pudendal nerve blocks and botulinum toxin. Tricyclic antidepressants and anticonvulsants also can be used for vulvodynia pain control.

• #85 What is Vulvodynia?

  https://www.nva.org/what-is-vulvodynia/

  Vulvodynia, simply put, is chronic vulvar pain without an identifiable cause. […] The majority of women with localized vulvodynia have Provoked Vestibulodynia (PVD), in which pain occurs during or after pressure is applied to the vestibule, e.g., with: sexual intercourse, tampon insertion, a gynecologic examination, prolonged sitting, and/or wearing fitted pants. […] For women with generalized vulvodynia (GV), pain occurs spontaneously and is relatively constant, but there can be some periods of symptom relief.

• #86 Vaginal and vulval pain: know the different causes and… | Jean Hailes

  https://www.jeanhailes.org.au/news/vaginal-vulval-pain-know-the-different-causes-and-when-to-seek-help

  The pain of vulvodynia is often described as a burning pain or discomfort in the vulva. It can be located in one area or across the whole vulva. […] In vulvodynia, the pain cannot be linked to a specific cause. It may or may not be triggered by touch. Provoked vulvodynia means the pain occurs with touch, such as inserting a tampon or attempting sex, whereas unprovoked vulvodynia means the pain is there all the time. […] Dr Farrell says its important to know that women with vulvodynia have a normal-looking vulva that is, there is no sign of irritation, inflammation or disease. […] Vulvodynia is a chronic pain condition that can last for months or years, but can often be treated with a multidisciplinary team of health professionals.

• #87 Persistent Vulvar Pain | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/09/persistent-vulvar-pain

  Vulvar pain can be caused by a specific disorder or it can be idiopathic. Idiopathic vulvar pain is classified as vulvodynia. […] The classification of vulvodynia is based on the site of the pain; whether it is generalized, localized, or mixed; whether it is provoked, spontaneous, or mixed; whether the onset is primary or secondary; and the temporal pattern (whether the pain is intermittent, persistent, constant, immediate, or delayed). […] Vulvodynia is a diagnosis of exclusion. Thus, excluding other treatable causes before assigning this diagnosis is imperative. […] A musculoskeletal evaluation would help rule out musculoskeletal factors associated with vulvodynia, such as pelvic muscle overactivity and myofascial or other biomechanical disorders. […] Medications used to treat vulvar pain include topical, oral, and intralesional medicinal substances, as well as pudendal nerve blocks and botulinum toxin. Tricyclic antidepressants and anticonvulsants also can be used for vulvodynia pain control.

• #88

  https://www.gloshospitals.nhs.uk/your-visit/patient-information-leaflets/vulvodynia/

  Vulvodynia is the medical term used to describe pain in the vulva or female genital area where the skin looks healthy and no cause has been found. This discomfort can be felt during normal touch such as sex, inserting tampons or from clothing. […] We are unsure what the reason is for developing this pain, but current research suggests it is because of a nerve problem. […] In some women the nerve endings become sensitive and interpret normal touch as pain (provoked vulvodynia). Giving birth, skin conditions such as eczema or lichen sclerosus and infections which can cause inflammation such as thrush, may trigger vulvodynia. […] Some women will have pain that is not triggered by touch (spontaneous or unprovoked vulvodynia). We do not know the exact cause of this pain but some studies have shown links to other chronic pain conditions such as fibromyalgia or irritable bowel syndrome.

• #89 Vulvodynia

  https://www.sandyford.scot/sexual-health-services/gynaecology/vulvodynia/

  Vulvodynia describes the sensation of vulval burning and soreness in the absence of any obvious skin condition or infection. The discomfort can be continuous (unprovoked vulvodynia) or on light touch eg. sexual intercourse or tampon use (provoked vulvodynia). Vestibulodynia occurs when this affects the vestibular area. Some women have symptoms which overlap between both. […] This is often a consequence of irritation or hypersensitivity of the nerve fibres in the skin. This is felt as pain by the woman. This type of pain can occur even when the area is not touched. […] In the majority of women with vulvodynia no cause is found. Around one third of women can pinpoint the time the symptoms developed. This was usually around the time of thrush or a urinary tract infection. Once this settled they were left with sensitivity on the nerve endings.

• #90 Persistent Vulvar Pain | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/09/persistent-vulvar-pain

  Vulvar pain can be caused by a specific disorder or it can be idiopathic. Idiopathic vulvar pain is classified as vulvodynia. […] The classification of vulvodynia is based on the site of the pain; whether it is generalized, localized, or mixed; whether it is provoked, spontaneous, or mixed; whether the onset is primary or secondary; and the temporal pattern (whether the pain is intermittent, persistent, constant, immediate, or delayed). […] Vulvodynia is a diagnosis of exclusion. Thus, excluding other treatable causes before assigning this diagnosis is imperative. […] A musculoskeletal evaluation would help rule out musculoskeletal factors associated with vulvodynia, such as pelvic muscle overactivity and myofascial or other biomechanical disorders. […] Medications used to treat vulvar pain include topical, oral, and intralesional medicinal substances, as well as pudendal nerve blocks and botulinum toxin. Tricyclic antidepressants and anticonvulsants also can be used for vulvodynia pain control.

• #91 Vestibulodynia | San Diego Sexual Medicine

  https://www.sdsm.info/female-issues/vestibulodynia

  For women with secondary or acquired provoked vestibulodynia, researchers have shown the high density of pain nerves in the vestibule has occurred as the result of healing cells called mast cells excessively releasing a protein called nerve growth factor. […] Additional factors are theorized to play a role in why there is thought to be acquired provoked vestibulodynia. It is now observed that some women with acquired secondary provoked vestibulodynia have the existence of different DNA sequences in genes that express important enzymes. […] There are multiple other causes of provoked vulvodynia or provoked vestibulodynia including dermatologic conditions such as lichen sclerosus, and lichen planus, infectious reasons such as chronic infection from candida, tissue injury reasons from a fissure that forms in the posterior fourchette often related to poorly healing episiotomy repairs post-partum. […] Additionally, if a woman experiences decreased libido and/or lubrication after starting hormonal contraceptives, she should be aware that hormonal contraceptives may lead to provoked vestibulodynia.

• #92 Vulvodynia and vestibulodynia – BAD Patient Hub

  https://www.skinhealthinfo.org.uk/condition/vulvodynia-and-vestibulodynia/

  Vulvodynia means ongoing pain in the vulva (the female genital area from the clitoris to the perineum including the labia) when there is nothing abnormal to see and no known cause for the pain; and other diagnoses have been ruled out by examination and investigation. […] The precise cause is unknown. The nerve endings in the skin of the vulva appear to become hypersensitive and account for the pain felt. Vulvodynia is one type of complex regional pain syndrome, others including migraine and fibromyalgia. Stress is known to worsen the condition. […] It may be primary (with no known cause) or secondary (following another condition). Secondary vulvodynia may follow inflammation in the vulva, such as that caused by thrush or the overuse of topical and vaginal anti-thrush treatments. […] Pain occurs in the vulva, and occasionally involves the buttocks or even the inner thighs. It is often felt as a burning, stinging or raw sandpaper-like discomfort.

• #93 Vulvodynia — Pelvic Health Physio

  https://www.pelvichealth-physio.com/vulvodynia

  Vulvodynia means ongoing pain (usually described as burning) in the vulva (the female genital area) when there is nothing abnormal to see and no known cause for the pain. […] The precise cause is unknown. The nerve endings in the skin of the vulva appear to become over-sensitive and send abnormal signals which are felt as a sensation of pain. […] It may be primary (with no known cause) or secondary (following another condition, usually one in which there is inflammation in the vulva, such as that from thrush).

• #94 Vestibulodynia | San Diego Sexual Medicine

  https://www.sdsm.info/female-issues/vestibulodynia

  Other research to understand the basis for disease in the vestibule that avoids the tissues of the vulva and the vagina is based on a non-hormonal theory. Multiple investigations have observed a proliferation or growth of pain nerves, called c-afferent nociceptors in the skin layer of the vestibule. In some patients with provoked vestibulodynia, there has been found to exist a 10-fold increase in the density of pain fiber nerve endings in the vestibule skin lining compared to women who did not have provoked vestibulodynia. […] For women with primary or lifetime provoked vestibulodynia, it is felt by some experts that the high density of pain nerves in the vestibule has occurred as the result of a congenital accumulation of nerve fibers, called congenital neuronal hyperplasia, in the tissue derived from the urethral/bladder region or the primitive urogenital sinus.

• #95 Vulvodynia: Causes, Symptoms, Management & Treatment

  https://my.clevelandclinic.org/health/diseases/17878-vulvodynia

  Data suggests that people with vulvodynia are more likely to have higher levels of stress, histories of abuse and certain behavioral health conditions, including: Anxiety, Depression, Post-traumatic stress disorder (PTSD). […] Unfortunately, vulvodynia isn’t preventable. […] There isn’t enough evidence to predict when (or if) your vulvodynia will ease or resolve on its own.

• #96 Vulvodynia: Causes, Symptoms, and Treatments

  https://www.webmd.com/women/vulvodynia

  Vulvodynia is a chronic pain condition affecting the vulva (outer female genitals). It usually lasts more than three months, and there’s no known cause. […] Doctors don’t know the cause of most forms of vulvodynia. And there’s no proof that infections, such as sexually transmitted diseases(STDs), lead to vulvodynia. […] Researchers are trying to find the causes. They may include: Nerve injury or irritation, Abnormal response in vulvar cells to an infection or trauma, Genetic factors that cause the vulva to react poorly to chronic inflammation, Hypersensitivity to yeast infections, Muscle spasms, Allergies or irritation to chemicals or other substances, Hormonal changes, A history of sexual abuse, Frequent antibiotic use. […] Possible risk factors for vulvodynia include: Anxiety, Depression, A history of abuse, Posttraumatic stress disorder (PTSD).

• #97 Persistent Vulvar Pain? Learn About Vulvodynia Symptoms, Causes, and Treatments

  https://www.chicagopelvic.com/blog/persistent-vulvar-pain-vulvodynia-explained

  Persistent vulvar pain can be distressing and confusing, especially when the cause is unclear. If you experience pain in the vulva that lasts for three months or more, you might have a condition called vulvodynia. […] The exact cause of vulvodynia is not well understood, and it can occur at any age, although it is most common among young women between the ages of 18 and 25. […] The exact cause of vulvodynia is often unknown, but several factors have been hypothesized to contribute to its development: […] Pelvic Floor Muscle Dysfunction: Tight or weak pelvic floor muscles can contribute to pain. […] Pelvic Nerve Irritation or Injury: Nerve irritation or injury in the pelvic region can lead to vulvar pain. […] Hormonal Imbalance: Changes in hormone levels, particularly estrogen, can affect vulvar health.

• #98 Vulvodynia | HealthLink BC

  https://www.healthlinkbc.ca/healthwise/vulvodynia

  Vulvodynia is pain in the vulva that can’t be explained by another health problem, such as an infection or a skin problem. […] Doctors don’t know the exact cause of vulvodynia. But some things that may help cause it include: Swelling of or injury to the nerves of the vulva. Spasms or weakness of the muscles that support the organs of the pelvis. A family history of vulvodynia. […] In most cases, vulvar pain is a symptom of some other problem. And when that problem is treated, the pain often goes away. Some conditions that may cause vulvar pain include yeast infections and other vaginal infections, atrophic vaginitis, lichen sclerosus, lichen planus, or an allergic reaction to soaps or other products, such as vaginal sprays or douches. […] If a cause for your pain is not found, you may have vulvodynia.

• #99 Persistent Vulvar Pain? Learn About Vulvodynia Symptoms, Causes, and Treatments

  https://www.chicagopelvic.com/blog/persistent-vulvar-pain-vulvodynia-explained

  Allergic Reactions: Allergies to products like soaps, lotions, or fabrics can cause vulvar irritation and pain. […] Recurring Vaginal Infections: Frequent yeast infections or bacterial vaginosis can cause an elevated inflammatory response that irritate the vulva and cause pain. […] Certain factors may increase the risk of developing vulvodynia, including: […] Pelvic Floor Muscle Dysfunction: Women with pelvic floor issues may be more prone to vulvar pain. […] Having Certain Allergies: Allergic reactions to personal care products or medications can increase the risk. […] Autoimmune Disorders: Conditions like Lichen Sclerosis, an autoimmune disease, can cause chronic vulvar pain. […] Recurrent Vaginal Infections: Frequent infections can lead to inflammation and pain in the vulva.

• #100 What Causes Vulvodynia and What Does That Mean? | Vulvar Specialist NY | Pelvic Pain Doc

  https://www.pelvicpaindoc.com/blog/what-causes-vulvodynia-and-what-does-it-mean/

  Vulvar pain could be a sign of vulvodynia a chronic pain around the vaginal opening that typically doesnt have one specific cause. […] We dont know of one specific cause of vulvodynia yet, but Dr. Bahlani can narrow it down to a few suspected causes depending on a patients health history. Vulvodynia can be associated with: Past vaginal infections, Injury or trauma to the vulvar area, Hormonal changes, Allergies or sensitive skin, Reactions to certain foods, Disorders in the pelvic floor, Muscle spasms or a weak pelvic floor, Genetic factors, Other health conditions like diabetes, Neuroproliferative changes. […] We should mention that vulvodynia isnt always acting alone. Women with vulvodynia often concurrently suffer from conditions affecting their overall health or other areas of the body. Painful bladder syndrome, fibromyalgia, irritable bowel syndrome, or TMJD temporomandibular disorder are all common examples.

• #101 Vulvodynia | Doctor

  https://patient.info/doctor/vulvodynia-pro

  Vulvodynia has many possible treatments; however, very few controlled trials have been performed to verify efficacy of these treatments. Aetiology is not understood and is likely to be multifactorial. There are a number of theories which include: A trigger causing inflammation or injury, causing stimulation of pain receptors, and receptor/nerve damage. Triggers possibly involved could be infections, skin conditions, allergies, trauma or hormonal factors. General urogenital hypersensitivity. Disordered central pain processing. Somatoform pain disorder. […] Associations with other chronic pain conditions are common, with one study finding 45% of women with vulvodynia also having one of the following: Fibromyalgia, Irritable bowel syndrome, Chronic fatigue syndrome, Interstitial cystitis, Endometriosis. A history of recurrent vulvovaginal candidiasis is commonly associated. Women with a past history of anxiety and/or depression are more likely to get vulvodynia. […] The natural history of this disorder is not clear. There is a high placebo effect in trials, suggesting high rates of spontaneous improvement in symptoms. Many treatment options have shown good success rates. However, improvement may take time and a combination of therapies.

• #102 Vulvodynia – Wikipedia

  https://en.wikipedia.org/wiki/Vulvodynia

  Other possible causes include Sjgren syndrome, the symptoms of which include chronic vaginal dryness. Others include genetic predisposition to inflammation, allergy or other sensitivity (for example: oxalates in the urine), an autoimmune disorder similar to lupus erythematosus or to eczema or to lichen sclerosus, infection (e.g., yeast infections, bacterial vaginosis, HPV, HSV), injury, and neuropathy including an increased number of nerve endings in the vaginal area. Some cases seem to be negative outcomes of genital surgery, such as a labioplasty. […] Pelvic floor dysfunction may be the underlying cause of some women’s pain. […] Many co-morbidities are commonly associated with vulvodynia, including fibromyalgia, irritable bowel syndrome, interstitial cystitis, pelvic floor dysfunction, endometriosis, depression and anxiety disorders.

• #103 Persistent Vulvar Pain? Learn About Vulvodynia Symptoms, Causes, and Treatments

  https://www.chicagopelvic.com/blog/persistent-vulvar-pain-vulvodynia-explained

  Allergic Reactions: Allergies to products like soaps, lotions, or fabrics can cause vulvar irritation and pain. […] Recurring Vaginal Infections: Frequent yeast infections or bacterial vaginosis can cause an elevated inflammatory response that irritate the vulva and cause pain. […] Certain factors may increase the risk of developing vulvodynia, including: […] Pelvic Floor Muscle Dysfunction: Women with pelvic floor issues may be more prone to vulvar pain. […] Having Certain Allergies: Allergic reactions to personal care products or medications can increase the risk. […] Autoimmune Disorders: Conditions like Lichen Sclerosis, an autoimmune disease, can cause chronic vulvar pain. […] Recurrent Vaginal Infections: Frequent infections can lead to inflammation and pain in the vulva.

• #104 Vulval Pain | Pelvic Pain Support Network

  https://www.pelvicpain.org.uk/conditions/vulval-pain/

  Vulval pain may be related to several causes including infections such as candidosis or herpes, skin conditions (dermatosis) and occasionally precancerous or malignant conditions. […] Some data suggest that this pain may arise from persistent inflammatory damage to tissue. Some women may make more chemicals that increase or cause inflammation. […] Persistent infections may cause irritated vulvar tissue. […] The vestibule is the most frequently affected site of provoked vulvodynia (previously called vestibulitis). […] Most doctors, including some gynaecologists, may never have heard of vulvodynia. […] The management of vulval pain should follow the principles of chronic pain management. […] Those with vulvodynia, either spontaneous or provoked by touch, usually have pelvic floor muscle dysfunction.

• #105 Vulvodynia: Causes, Symptoms, Management & Treatment

  https://my.clevelandclinic.org/health/diseases/17878-vulvodynia

  Data suggests that people with vulvodynia are more likely to have higher levels of stress, histories of abuse and certain behavioral health conditions, including: Anxiety, Depression, Post-traumatic stress disorder (PTSD). […] Unfortunately, vulvodynia isn’t preventable. […] There isn’t enough evidence to predict when (or if) your vulvodynia will ease or resolve on its own.

• #106 Persistent Vulvar Pain? Learn About Vulvodynia Symptoms, Causes, and Treatments

  https://www.chicagopelvic.com/blog/persistent-vulvar-pain-vulvodynia-explained

  Exposure to Birth Control: Hormonal birth control methods may affect vulvar sensitivity. […] Stress, Anxiety, Depression, or Emotional Trauma: Mental health issues can amplify physical pain, including vulvar pain. […] Pelvic Pain Disorders: Conditions like painful bladder syndrome (interstitial cystitis) or endometriosis can increase the risk of vulvodynia.

• #107 arrow-right

  https://middlesexmd.com/pages/vulvodynia-vvs?srsltid=AfmBOop2lj3j-YA2xkO8WcrkjKap02txjwiE65HGdXR5R9DcCJWuCCb_

  Vulvodynia is a complex condition that manifests as chronic pain in the vulvar region – the external part of the female genitalia. […] Unlike other vulvar conditions that may have identifiable causes or lesions, vulvodynia is characterized by pain without an evident origin or disease, making diagnosis and treatment challenging. […] While the exact cause is not always clear, researchers believe that several factors may contribute to the development of vulvodynia. […] A history of sexual abuse or trauma may sometimes lead to the development of vulvodynia, as it can cause long-term pelvic floor dysfunction and pain. […] Injury or irritation to the nerves in the vulval area, possibly from surgery, childbirth, or other trauma, can lead to chronic pain that characterizes vulvodynia. […] Fluctuations in hormone levels, particularly estrogen, have been linked to vulvar pain.

• #108 What Is Vulvodynia? Causes, Symptoms, and More | Evvy

  https://www.evvy.com/blog/what-is-vulvodynia

  According to one theory, there could be a primary trigger that causes inflammation or direct trauma to the vulva that then would stimulate the pain receptors. Possible triggers could be genetic or immune factors, infection, or damage to the nervous system. […] Emotional and psychosocial factors, such as the state of your relationships, can also influence your physical and sexual health. While these are recognized as being related to vulvodynia, there isnt really a clear understanding of how these factors are associated. […] Vulvodynia pain can also be associated with changes in hormone levels from taking birth control pills or entering menopause, for example. […] Because we know so little about vulvodynia its hard to say who is more likely to get it. One study found that people who had poorer sleep quality, other chronic pain conditions, PTSD, a history of vulvodynia, and other urogenital symptoms were more likely to get vulvodynia than people who werent affected by those factors. But, again, more research is needed.

• #109 Vulvodynia: Symptoms, treatment, and tips

  https://www.medicalnewstoday.com/articles/189076

  Other factors that increase susceptibility include: frequent yeast infections, sexually transmitted infections (STIs), chemical irritation of the external genitals, caused by soaps, feminine hygiene products or detergents in clothing, rashes on the genital area, previous laser treatments or surgery on the external genitals, nerve irritation, injury or muscle spasms in the pelvic area, diabetes, precancerous or cancerous conditions on the cervix. […] Provoked vestibulodynia could result from: sexual intercourse, tampon insertion, a gynecologic examination, prolonged sitting, wearing tight underclothes or pants, activities such as cycling or horseback riding.

• #110 Vulvodynia: Symptoms, treatment, and tips

  https://www.medicalnewstoday.com/articles/189076

  Other factors that increase susceptibility include: frequent yeast infections, sexually transmitted infections (STIs), chemical irritation of the external genitals, caused by soaps, feminine hygiene products or detergents in clothing, rashes on the genital area, previous laser treatments or surgery on the external genitals, nerve irritation, injury or muscle spasms in the pelvic area, diabetes, precancerous or cancerous conditions on the cervix. […] Provoked vestibulodynia could result from: sexual intercourse, tampon insertion, a gynecologic examination, prolonged sitting, wearing tight underclothes or pants, activities such as cycling or horseback riding.

• #111 Vulvodynia – Assoc. Prof. Süleyman Eserdağ, MD

  https://www.eserdag.com/en/vulvodynia

  Irritants, previously encountered HPV infection, using oral contraceptive, vaginal candidiasis, psychological reasons, autoimmune diseases. […] In some studies conducted in recent years, vulvodynia was found to be more common in women with autoimmune diseases such as fibromyalgia and interstitial cystitis. […] Not all pain in the vulva or vestibulum is vulvodynia. […] Chronic irritation that may be due to some conditions such as constant scratching or the use of synthetic clothes is one the causes of vulvodynia, as well. […] Vulvodynia may also appear due to atrophy (thinning) that can occur in the skin as a result of hormonal deficiencies, especially estrogen deficiency during menopause. […] The reason of this is not that the lack of diagnostic methods for the disease, but the fact that physicians usually do not remember the possibility of a diagnosis of vulvodynia.

• #112 What is Vulvodynia and What Causes It?

  https://cherokeewomenshealth.com/2016/09/what-is-vulvodynia-and-what-causes-it/

  Vulvodynia is persistent, inexplicable pain anywhere in the vulva. […] Though it is not known exactly what causes Vulvodynia, doctors speculate that there may be several triggers: Allergies or sensitive skin that can be easily irritated, hormonal changes or hormonal contraception, injuries to the vulvar areas surrounding nerves, sexual abuse, a predisposition to yeast infections, pelvic floor dysfunction, past history of anxiety and/or depression, muscle spasms, frequent antibiotic use. […] In most cases, however, there is no absolute known cause, and the reasons for Vulvodynia remain a mystery. […] Vulvodynia has also been associated with several other chronic pain-related conditions, meaning that there is a higher likelihood of vulvodynia if a woman has any of the following: Interstitial cystitis, fibromyalgia, irritable bowel syndrome, endometriosis, chronic fatigue syndrome.

• #113 Etiology, diagnosis, and clinical management of vulvodynia | IJWH

  https://www.dovepress.com/etiology-diagnosis-and-clinical-management-of-vulvodynia-peer-reviewed-fulltext-article-IJWH

  Conversely, the initial trigger may not involve peripheral sensitization of the vulva, but rather begin with generalized urogenital, pelvic, and/or central nervous sensitivity. […] Women with vulvodynia have been found to have generalized hypersensitivity, a decreased pain threshold in the vulvar area as well as other areas of the body, and enhanced pain processing. […] Central sensitization may in fact precede the peripheral sensitization. […] These etiologic theories position vulvodynia as a neuropathic disorder. However, some authors have suggested that vulvodynia is a somatoform or functional pain disorder, ie, a type of somatic pain syndrome similar to fibromyalgia, interstitial cystitis, and/or irritable bowel syndrome. […] It is often impossible for a woman with vulvodynia and/or her clinician to confidently identify a single biological cause for her pain.

• #114 Conditions – The Centers for Vulvovaginal Disorders

  https://vulvodynia.com/conditions/vulvodynia

  Odyne was the „Greek goddess of pain.” Therefore, the term vulvodynia literally means „vulvar pain.” Vulvodynia is currently defined as „vulvar discomfort, most often described as burning pain, occurring in the absence of relevant visible findings or a specific, clinically identifiable disease.” […] The cause of vulvodynia remains elusive, but it most likely occurs from a variety of sources and represents many different disease processes. Possible causes include abnormalities of embryologic development, genetic and/or immunologic factors, hormonal factors, peripheral and central neuropathy (nerve damage), allergic reactions, tightness of the muscles of the pelvic floor, and nerve entrapment. In essence, it is likely that there are many different diseases that yield similar symptoms and cause „vulvodynia.”

• #115 Persistent Vulvar Pain | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/09/persistent-vulvar-pain

  Women with vulvodynia should be assessed for pelvic floor dysfunction. Biofeedback and physical therapy, including pelvic floor physical therapy, can be used to treat localized and generalized vulvar pain. […] An emerging treatment for vulvodynia is transcutaneous electrical nerve stimulation. […] When other nonsurgical management options have been tried and failed, and the pain is localized to the vestibule, vestibulectomy may be an effective treatment. […] Although optimal treatment remains unclear, consider an individualized, multidisciplinary approach to address all physical and emotional aspects possibly attributable to vulvodynia. […] Future research should aim at evaluating a multimodal approach in the treatment of vulvodynia, along with more research on the etiologies of vulvodynia.

• #116 Persistent Vulvar Pain | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/09/persistent-vulvar-pain

  Persistent vulvar pain is a complex disorder that frequently is frustrating to the patient and the clinician. It can be difficult to treat and rapid resolution is unusual, even with appropriate therapy. Vulvar pain can be caused by a specific disorder or it can be idiopathic. Idiopathic vulvar pain is classified as vulvodynia. […] Although optimal treatment remains unclear, consider an individualized, multidisciplinary approach to address all physical and emotional aspects possibly attributable to vulvodynia. […] Proposed etiologies include abnormalities that stem from early fetal development, genetic or immune factors, hormonal factors, inflammation, infection, neuropathic changes, and dietary oxalates. However, given the variable presentation and individualized responses to treatment, causation is very likely multifactorial.

• #117

  https://www.yourdaye.com/en-us/vitals/womens-health/vulvodynia-why-does-my-vulva-hurt/?srsltid=AfmBOooLc9nYKRh2tZoAEklxplC0hkKPfkU0zWJwsdh4XeHfNJ2IvOmm

  Vulvodynia causes burning, stinging or irritation, that doesnt have an identifiable cause and isnt visible. […] As with many gynaecological issues, vulvodynia is severely under-researched and misunderstood, which makes diagnosing and treating the condition very difficult. […] Because of its unknown cause, many doctors still believe that its nothing more than a psychosomatic condition associated with mental health. […] Despite its high prevalence, vulvodynia is still often dismissed as a psychological condition. […] Vulvodynia is also sometimes referred to as a depressed vagina, which is disconcerting for several reasons chief among them that it affects the vulva, not the vagina. […] Its also due to the fact that since it can be a frustrating and debilitating condition, sufferers often experience symptoms of depression and anxiety, so antidepressants and cognitive behavioural therapy are commonly prescribed as a treatment for vulvodynia.

• #118 Vulvodynia – Assoc. Prof. Süleyman Eserdağ, MD

  https://www.eserdag.com/en/vulvodynia

  However, the source of the problem in vulvodynia is mostly physical, not psychological. […] The first step to take before starting vulvodynia treatment should be to eliminate the factors that increase the pain. […] Vulvodynia treatment should be performed step by step. […] The most appropriate surgical procedures from local excision to vestibulectomy and perineoplasty can be preferred for the patient. […] Vulvodynia is a serious problem that can affect both the person herself and her relationship.

• #119 Vulvar pain of unknown cause (vulvodynia): Treatment – UpToDate

  https://www.uptodate.com/contents/vulvar-pain-of-unknown-cause-vulvodynia-treatment

  Vulvodynia, or vulvar pain of an unknown cause, has a significant negative impact on a woman’s health, self-esteem, relationships, quality of life, and work productivity. Women can have vulvar pain from a specific etiology, pain without an identifiable cause, or both. Treatment must therefore address a wide range of potential etiologies as well as provide an approach for women whose pain is not understood by available paradigms. […] The evaluation of women with vulvar pain, approach to the woman with sexual pain, and evaluation and treatment of vulvar pain from specific etiologies are reviewed separately.

• #120 Persistent Vulvar Pain | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/09/persistent-vulvar-pain

  Women with vulvodynia should be assessed for pelvic floor dysfunction. Biofeedback and physical therapy, including pelvic floor physical therapy, can be used to treat localized and generalized vulvar pain. […] An emerging treatment for vulvodynia is transcutaneous electrical nerve stimulation. […] When other nonsurgical management options have been tried and failed, and the pain is localized to the vestibule, vestibulectomy may be an effective treatment. […] Although optimal treatment remains unclear, consider an individualized, multidisciplinary approach to address all physical and emotional aspects possibly attributable to vulvodynia. […] Future research should aim at evaluating a multimodal approach in the treatment of vulvodynia, along with more research on the etiologies of vulvodynia.

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