Materiały źródłowe

• #1 Vulvodynia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vulvodynia/diagnosis-treatment/drc-20353427

  Vulvodynia treatments focus on relieving symptoms. No one treatment works in every case. For many people, a mix of treatments works best. It can take time to find the right combination. It also can take months to get relief. […] Your health care team may recommend medicines such as: […] Antidepressants or anticonvulsants. These can help ease long-term pain. Some types of antidepressants come in the form of creams that can be put on the skin. […] Local anesthetics. These stronger medicines can block pain for a short time. For example, you might put a local anesthetic called lidocaine ointment on your vulva 30 minutes before you have sex to make it more comfortable. This medicine can cause your partner to lose feeling for a little while after sexual contact. […] Nerve blocks. These shots are given near a nerve or group of nerves that are sensitive to pain. These might help if you have long-standing pain that doesn’t respond to other treatments.

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

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

  Vulvodynia treatment takes time. Finding the treatment or combination of treatments that bring you pain relief involves trial and error. Treatments that eventually work might not work immediately. […] Treatments may include: […] Physical therapy: Physical therapy can loosen muscle tension in your pelvic floor (the muscles, ligaments and connective tissue in your pelvis). It may also reduce how often your pelvic floor muscles spasm (contract involuntarily). Muscle spasms are common with vulvodynia. Treatment may involve stretching, lengthening and strengthening weak pelvic floor muscles. […] Counseling: Individual counseling, couples counseling or sex therapy may help you improve those areas of your life negatively impacted by vulvodynia, like sexual relationships. […] Unfortunately, vulvodynia isn’t an easy fix. The treatment that works for you will depend on what’s causing your pain. Medications, physical therapy, counseling and surgery are all potential solutions that can provide you pain relief. […] If you need quick pain relief, apply a topical anesthetic to numb the area that’s hurting. Finding long-term pain relief may take some trial and error as you work with your provider to find the proper treatment or combination of treatments.

• #3 Vulvodynia Treatments – The National Vulvodynia Association

  https://www.nva.org/learnpatient/medical-management/

  Vulvodynia Treatments […] Vulvodynia is not simply a gynecological disorder and experts typically recommend a multidisciplinary approach. […] It is a chronic pain condition of the vulva, and if you dont experience adequate relief with treatment prescribed by your gynecologist, treatment by a womens health physical therapist and/or a pain management specialist can be very helpful. […] A recent review of the research recommended both physical therapy and cognitive behavior therapy for women suffering from vulvodynia. […] At this time, there is no single treatment that helps every woman with vulvodynia. […] Finding the best treatment, or combination of treatments for you is a trial and error process. […] Health care professionals recommend eliminating over-the-counter feminine products such as perfumed bubble baths, soaps, sprays and douches that can irritate vulvar tissue. Eliminating irritants is typically the first step in treatment.

• #3 Vulvodynia Treatments – The National Vulvodynia Association

  https://www.nva.org/learnpatient/medical-management/

  Medications that are effective in alleviating other chronic pain conditions are often used in the treatment of vulvodynia. […] Even though TCAs were developed to treat depression, they have also been used to treat chronic pain. […] SNRIs, a relatively new type of antidepressant, work differently than the TCAs. […] Medications developed to inhibit seizures can also be effective in controlling some chronic pain syndromes. […] Pain-relieving opioids, such as oxycodone and hydrocodone, can be helpful for short-term use during vulvodynia flares. […] Topical medications applied directly to the vulva can help to alleviate pain, but some preparations contain additive substances that are irritating to the skin. […] Some women with vulvodynia also have pelvic floor muscle weakness or spasm. […] A pudendal nerve block injection uses local anesthetic and a steroid to numb the nerve and interrupt the transmission of pain signals.

• #4 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. It can have a big effect on your life, but there are treatments that can help. […] The main aim of treatment for vulvodynia is to help manage the pain. […] Vulvodynia is often treated by more than one specialist, including: a gynaecologist, a physiotherapist, a psychologist, a pain specialist. […] A number of different treatments may be recommended under the guidance of these specialists. […] Treatments for vulvodynia can include: medicines this may be a cream you rub on your vulva to numb the pain or tablets to treat nerve pain, pelvic floor exercises to help you control your vaginal muscles, gently widening your vagina using tampon-shaped objects (vaginal trainers), psychological therapies, such as cognitive behavioural therapy (CBT) or psychosexual therapy (therapy to help with sexual problems), surgery to remove the painful part of your vulva this may occasionally be offered if other treatments have not worked. […] No single treatment works for everyone, and you may need to try several treatments to find out what works best for you.

• #5 Persistent Vulvar Pain | ACOG

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

  ABSTRACT: 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. […] 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. […] 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.

• #6 Vulvodynia | ACOG

  https://www.acog.org/womens-health/faqs/vulvodynia

  How is vulvodynia treated? Many kinds of treatment are available. No one method works all the time for everyone. It can take a few months before any relief is noticed. Sometimes more than one treatment may be needed. Keeping a pain diary can help you track your symptoms and how they respond to different therapies. In some cases, your gynecologist or other health care professional may refer you to a pain specialist. A pain specialist may use techniques such as ultrasound and electrical stimulation to relieve pain. […] Several medications can be used to treat vulvodynia. Medications can be taken in pill form (oral), injected into the affected area, or applied to the skin (topical). The following medications have been found to be helpful in treating vulvodynia: Local anestheticsThese medications are applied to the skin. They may be used before sexual intercourse to provide short-term pain relief, or they can be used for extended periods. Antidepressants and antiseizure drugsDrugs used to treat depression and to prevent seizures also may help with the symptoms of vulvodynia. It may take a few weeks for these medications to work. Some types of antidepressants can be provided in the form of a cream that is applied to the skin. Hormone creamsEstrogen cream applied to the vulva may help relieve vulvodynia in some cases.

• #6 Vulvodynia | ACOG

  https://www.acog.org/womens-health/faqs/vulvodynia

  Physical therapy is another option for treating vulvodynia. This type of therapy can relax tissues in the pelvic floor and release tension in muscles and joints. Biofeedback is a form of physical therapy that trains you to strengthen the pelvic floor muscles. Strengthening these muscles may help lessen your pain. […] A nerve block is a type of anesthesia in which an anesthetic drug is injected into the nerves that carry pain signals from the vulva to the spinal cord. This treatment interrupts the pain signals and can provide short-term and sometimes long-term pain relief. Injection of a drug called botulinum toxin A (also known as Botox) has been used to treat vulvodynia. This drug relaxes muscles of the pelvic floor. […] Cognitive behavioral therapy may be suggested if you have vulvodynia. A counselor can help you learn to cope with chronic pain. This may reduce stress and help you feel more in control of your symptoms. Sexual counseling can provide support and education about this condition for you and your partner.

• #7 Vulvodynia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vulvodynia/diagnosis-treatment/drc-20353427

  Hormone creams. If your symptoms are linked to hormonal changes, you might get relief from estrogen cream that goes into your vagina. Sometimes it’s prescribed along with testosterone cream. […] Antihistamines. Often used to treat allergies, these medicines also might reduce itching from vulvodynia. But antihistamines may be drying if you are past menopause. […] Physical therapy includes various techniques that may ease your pain and improve your quality of life. These include: […] Pelvic floor therapy. Many people with vulvodynia have tension in the muscles of the pelvic floor, which supports the uterus, bladder and bowel. Exercises to stretch and relax those muscles can help ease vulvodynia pain. […] Your physical therapist also might recommend that you use a device at home called a vaginal dilator. This stretches and stimulates the vagina. It also may help ease the fear of having pain during sex.

• #8 Vulvodynia: Pain Management Strategies

  https://www.mdpi.com/1424-8247/15/12/1514

  In terms of specific treatments for vulvodynia, analgesic drugs are the best resource we have. The various drugs differ in their mode of action and administration. […] Topical lidocaine with 2–5% gel or cream is often tried in women with vulvodynia to reduce nociceptive sensitivity of the skin and mucous membranes and for desensitization of vestibular nerves. […] Tricyclic antidepressants (TCAs) are drugs considered first-line in the treatment of neuropathic pain. […] Anticonvulsants are often used in the treatment of vulvar pain but have been evaluated in a very small number of PVD studies. […] At present, it is not yet known whether chronic inflammation can represent a fulcrum in the development or exacerbation of vulvodynia; however, as reported by affected patients, the use of oral or topical NSAIDs is not effective in improving the painful sensation. […] Future studies are needed to draw up a unique therapeutic action plan that considers the stratification of patients with vulvodynia and the variability of the symptom.

• #9 Overview of treatment of vulvovaginal pain – Vulvovaginal Disorders

  https://vulvovaginaldisorders.org/treatment-plans/overview-of-treatment/

  Pharmacologic treatment for vulvodynia […] Topical medications […] Lidocaine 5% ointment […] Lidocaine has not been studied for generalized vulvodynia. […] We have found that lidocaine can be a helpful management modality for both types of vulvodynia. […] […] Topical tricyclic antidepressants or anticonvulsants […] A variety of topical medications, many compounded from medications used by mouth (e.g., amitriptyline, gabapentin), are being tried for the relief of pain, It is thought that these tend to have fewer side effects compared with oral forms. […] […] Injections and blocks […] Botulinum toxin injections are being used for both provoked and unprovoked pain, injected into the vestibule and/or pelvic floor muscles to reduce hypertonicity. […] In a systematic review, there was fair evidence of a lack of efficacy for botulium toxin injections for localized provoked vulvodynia. […]

• #10 Vulvodynia: Diagnosis and Management | AAFP

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

  Cognitive behavioral therapy should be used to decrease vulvar pain with intercourse. […] Biofeedback and physical therapy should be considered to help patients regain control of the pelvic floor musculature. […] Perineoplasty should be reserved for women with severe vulvodynia. […] Data are lacking about the effectiveness of various treatment options for vulvodynia, and many of the commonly recommended treatments have not been systematically studied in randomized controlled trials (RCTs). Nevertheless, several treatments have been used with varying degrees of success, and the responses to these treatments suggest that improvement should be expected in most women with vulvodynia. […] Because the pain of vulvodynia seems to be neuropathic, many medications that have been used effectively in the treatment of other neuropathic disorders have been used in patients with vulvodynia. Tricyclic antidepressants (TCAs) often are used as a first-line therapy.

• #11 Medication for the Treatment of Vulvodynia – London Pain Clinic

  https://www.londonpainclinic.com/antineuropathic-medication/medication-for-the-treatment-of-vulvodynia/

  Vulvodynia is one of the most severe forms of nerve or neuropathic pain. […] Researchers generally agree that nerve injury or irritation is prevalent in most cases. The pudendal nerve is the main nerve that runs through this area, so more advanced treatment for nerve pain is targeted here. […] The anti-neuropathic medication used to relieve nerve pain can be split into two groups, antidepressants and anticonvulsants. […] The tricyclic antidepressant amitriptyline is used to increase the levels of serotonin in the brain. […] Anticonvulsants, usually prescribed to treat epilepsy, are sometimes used in conjunction with tricyclic antidepressants. […] When combined with anti-neuropathic medication, non steroidal anti-inflammatory drugs (NSAIDs) have shown to significantly increase their pain-relieving effects. […] Studies have shown that opioids may effectively treat vulvodynia without the cognitive side effects associated with anti-neuropathic medication.

• #12 Vulvodynia: Causes, Symptoms, and Treatments

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

  Vulvodynia Treatments […] There’s no one treatment for vulvodynia that works for all women. You may need to try a mix of things for the best results. Your doctor may suggest: […] Medications […] You might get a pill, a cream, or an ointment you rub onto the skin, or a shot. These could include: […] Local anesthetics, such as lidocaine […] Topical estrogen creams […] Tricyclic antidepressants […] Anticonvulsants […] Nerve blocks […] Serotonin-norepinephrine reuptake inhibitors […] Neurostimulation and spinal infusion pump […] Medications with anti-inflammatory effects, such as steroids or mast cell inhibitors […] Botox […] Therapies […] The doctor may also suggest treatments such as: […] Physical therapy, which involves exercise to strengthen pelvic muscles and ease muscle spasms

• #13 Vulvodynia – The Vulval Pain Society

  https://vulvalpainsociety.org/about-vulval-pain/vulval-pain-conditions/vulvodynia/

  Pain that originates from nerve fibres is best treated with drugs that alter the way in which the nerve fibres send their impulses to the spinal cord and give the sensation of pain. The most experience to date in treating vulvodynia has been with the tricyclic antidepressants. These can be prescribed by your doctor in doses lower than are used to treat depression. The drugs are used because they alter the way in which the nerve fibres transmit the sensation of pain, not because the doctor thinks its all in your mind! […] Tricyclic antidepressant tablets, as mentioned above, are a standard treatment. The treatment is in tablet form, starting at a low dose and then increasing every few days until the pain subsides. The response to treatment does not happen overnight and may take several weeks. It is often necessary to continue with treatment for three to six months. Examples of tablets include amitriptyline, nortriptyline and dothiepin. […] Vaginal lubricants can help during intercourse. These are like vaginal mucus and last longer than conventional lubricants. […] Acupuncture has been shown to benefit women with vulvodynia when the pain is continuous; however, it is important to have treatments which address the genital area.

• #14 Conditions – The Centers for Vulvovaginal Disorders

  https://vulvodynia.com/conditions/vulvodynia

  Topical medications that have been used include estradiol, capsaicin, atropine, testosterone, nitroglycerine, doxepin, amitriptyline, baclofen, and gabapentin. Unfortunately, there are few adequate trials assessing the efficacy or safety of these medications in women with vulvodynia. […] Antidepressants are commonly used in the treatment of many chronic pain conditions. A common treatment for vulvodynia is the use of oral tricyclic antidepressants, such as amitriptyline (Elavil), nortriptyline (Pamelor), and desipramine (Norpramin). […] Physical therapy of the pelvic floor muscles is commonly employed in the treatment of vulvodynia, for both local and generalized pain. […] Recently, the use of botulinum toxin A (Botox) has been successfully used for the treatment of vulvodynia. Small clinical trials have shown significant reduction in pain scores in women with vulvodynia after intra-levator injections of botulinum toxin A.

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

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

  Vulvodynia treatment should be performed step by step. […] Vulvodynia treatment should be performed step by step. First, infections in the genital area or urinary tract should be eliminated using appropriate antimicrobial drugs. Then, the active treatment should be started. […] Local Anesthetic Creams: Usually creams with local anesthetic effect are recommended as the first option to use in the treatment. There are treatment methods such as applying creams containing 5% lidocaine only before sexual intercourse or applying a tampon to the painful area every night for a certain period of time. […] Hormone Containing Creams: There are studies showing that estrogen and testosterone containing creams reduce vulva pain. […] Injection Treatments: Local or intra-lesion injections of steroid and bupivacaine can be applied in the treatment of localized vulvodynia, and vestibulodynia in particular.

• #16

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

  Management options for vulvodynia […] There are a variety of treatments and sometimes a combination of options are needed. […] Physiotherapy […] There is strong evidence that physiotherapy, as a first-line treatment, can improve vaginismus and vulvodynia by up to 80%. […] Vaginal dilators […] These are cylinder shapes that come in different sizes. […] Lidocaine ointment (5%) […] This is an ointment which numbs the nerves when you put it on the skin. […] Pain modifying medication […] These medications can reduce pain signals from your nerves and are given in tablet form. […] Psychosexual counselling […] Lack of desire due to chronic pain can continue, even after the pain has improved with treatment, if these feelings are not talked about. […] Acupuncture […] Can reduce pain by 50% in women with unprovoked vulvodynia after 5 weeks of treatment. […] Cognitive Behavioural Therapy (CBT) […] Sexual pain is reduced by 50% and the benefits are still reported 2 years later. […] Botox injections […] This medication blocks the release of pain signals and can be considered if other therapies fail in women with provoked vulvodynia.

• #17 Vulvodynia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vulvodynia/diagnosis-treatment/drc-20353427

  Biofeedback. This mind-body technique can help relieve pain by teaching you how to relax your pelvic muscles. It also can teach you to control how your body responds to the symptoms. […] Talk therapy involves working with a therapist, who can teach you ways to cope with your pain. […] Surgery may be a treatment choice if you have pain in the tissue that surrounds the opening of your vagina, called the vestibule. Most often, surgery is done only if other treatments haven’t helped. […] Surgery can remove the painful vestibule tissue from the vulva. The procedure is called a vestibulectomy. If you have vulvodynia symptoms in other parts of your vulva, surgery likely isn’t a treatment option for you. […] Some treatments that aren’t part of standard medical care may help lessen vulvodynia symptoms. These include:

• #18 Vulvodynia Treatment: Causes, Symptoms & Care

  https://www.vuvatech.com/blogs/care/vulvodynia-treatment-causes-symptoms-care?srsltid=AfmBOoqOxCOjHchs9Q74mF-De8S-TWjOyqEY0v6LrOauqdceT4y8NaAg

  Are you looking for a vulvodynia treatment that works? […] The American College of Obstetricians says vulvodynia treatment should be individualized and can be treated by one or more of the followings ways: pelvic floor physical therapy with vaginal dilation, medications including oral, topical, and injectable, biofeedback training, dietary changes, sexual counseling, cognitive behavioral therapy, surgery. […] Vaginal Dilator Therapy is a type of physical therapy that uses vaginal dilators to treat and cure vulvodynia. […] Over 30,000 women around the world, suffering from vulvodynia and other pelvic pain conditions, have found relief with VuVatech vaginal dilators. […] Using vaginal dilators to stretch the vagina is a safe and effective way to treat the pain syndrome associated with vulvodynia.

• #19 Vulvodynia: Diagnosis and Management | AAFP

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

  One RCT has shown that cognitive behavioral therapy is associated with a 30 percent decrease in reported vulvar pain with intercourse. […] Biofeedback and physical therapy have been used to reverse changes in the pelvic floor musculature and to help women regain control of the muscles, including improving strength and relaxation. […] Surgery is one of the oldest therapies for localized vulvar vestibulodynia, but this therapy typically is reserved for women with severe, debilitating symptoms that are localized to the introitus. Several studies have found subjective improvement in pain in 60 to 80 percent of women who underwent surgery. […] A three-armed treatment trial comparing surgery with biofeedback and cognitive behavioral therapy found that women who underwent perineoplasty had greater reductions in pain than those who were treated with biofeedback or cognitive behavioral therapy. […] The prognosis for women who receive appropriate treatment is quite good. A follow-up study of 104 women seen in two referral clinics at the University of Michigan suggests that most women with vulvodynia experience substantial improvement with medical treatment.

• #20 Vulvodynia | The Children’s Hospital at Montefiore

  https://www.cham.org/health-library/article?id=bo1196

  There are other things you can try to relieve your symptoms: Always clean your vulva gently. Avoid soaps and other products, such as vaginal sprays or douches, that irritate your skin. Wear loose-fitting cotton clothes. Avoid nylon and other fabrics that hold moisture close to the skin. This may cause irritation and allow an infection to start. Avoid hot baths, and don’t use soaps or bath products to wash your vulva. Rinse with water only, and gently pat the area dry. Relieve itching and pain with a cold water compress or a cool bath. Don’t scratch the area. Try using a vaginal lubricant, such as Astroglide or K-Y Jelly, to reduce irritation from having sex. Stay active. But limit exercises that can irritate the vulva, such as bike riding or horseback riding. […] Cognitive-behavioral therapy allows you to express your emotions and concerns and to learn new ways of coping with vulvar pain. Sex therapy can also help you and your partner find ways to be intimate that don’t cause pain.

• #21 Vulvodynia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vulvodynia/diagnosis-treatment/drc-20353427

  Acupuncture. A trained practitioner places very fine needles into specific parts of the body. […] Hypnosis. A health professional guides you into a changed state of awareness that may help you relax and focus. […] Mindfulness and meditation. You can learn these techniques through self-instruction with practice and with apps. […] Transcutaneous electrical nerve stimulation. A device placed on the skin sends low-voltage electrical currents to the painful area.

• #22 Vulvodynia | The Children’s Hospital at Montefiore

  https://www.cham.org/health-library/article?id=bo1196

  You can track moods, thoughts, activities, and medicines that affect pain. Having a record of pain can help you and your doctor find the best ways to treat it. […] A support group can help you share your concerns and hear how other people cope with the pain and challenges of living with vulvodynia. […] Meditation and guided imagery are two examples of how you can reduce stress and relax your mind and muscles.

• #23 Vulvodynia | ACOG

  https://www.acog.org/womens-health/faqs/vulvodynia

  A vestibulectomy is the removal of the painful tissue from the part of the vulva called the vestibule. It can be used for women who have vulvodynia specific to this area and for whom other treatments have not worked. It is not recommended for women with vulvodynia that is not limited to the vestibule.

• #24 Persistent Vulvar Pain | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/09/persistent-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. […] For generalized vulvar burning unresponsive to previous behavioral and medical treatments, referral to a pain specialist may be helpful.

• #25 Vulvodynia Treatments – The National Vulvodynia Association

  https://www.nva.org/learnpatient/medical-management/

  Some women find that eating a certain food increases their pain and that elimination of the food alleviates it. […] In severe cases, when more conservative forms of treatment haven’t worked, neurostimulation or implantation of a spinal infusion pump may be recommended. […] Since living with chronic vulvar pain usually affects a womans sexual relationship and can lead to anxiety and/or depression, some women find it helps to see a psychologist or a couples/sex therapist. […] Surgery is contraindicated for women with Generalized Vulvodynia. […] Most published results are based on vestibulectomy with vaginal advancement. […] The treatments described above are, by far, the most common ones, but your provider may recommend another approach for your specific case.

• #26 Vulvodynia Information | Mount Sinai – New York

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

  The goal of the treatment is to reduce pain and relieve symptoms. No one treatment works for all women. You also may need more than one type of treatment to manage your symptoms. […] You may be prescribed medicines to help relieve pain, including: Anticonvulsants, Antidepressants, Opioids, Topical creams or ointments, such as lidocaine ointment or estrogen or testosterone cream. […] Other treatments and methods that may help include: Physical therapy to strengthen the pelvic floor muscles, Biofeedback, which helps relieve pain by teaching you to relax your pelvic floor muscles, Injections of nerve blocks to decrease nerve pain, Cognitive behavioral therapy to help you deal with your feelings and emotions, Diet changes to avoid foods with oxalates, including spinach, beets, peanuts, and chocolate, Acupuncture may help to relieve pain, but be sure to find a practitioner familiar with treating vulvodynia, Other complementary medicine practices such as relaxation and meditation.

• #27

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=bo1196

  There are other things you can try to relieve your symptoms: Always clean your vulva gently. Avoid soaps and other products, such as vaginal sprays or douches, that irritate your skin. Wear loose-fitting cotton clothes. Avoid nylon and other fabrics that hold moisture close to the skin. This may cause irritation and allow an infection to start. Avoid hot baths, and don’t use soaps or bath products to wash your vulva. Rinse with water only, and gently pat the area dry. Relieve itching and pain with a cold water compress or a cool bath. Don’t scratch the area. Try using a vaginal lubricant, such as Astroglide or K-Y Jelly, to reduce irritation from having sex. Stay active. But limit exercises that can irritate the vulva, such as bike riding or horseback riding. […] Cognitive behavioural therapy allows you to express your emotions and concerns and to learn new ways of coping with vulvar pain. Sex therapy can also help you and your partner find ways to be intimate that don’t cause pain.

• #28

  https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=bo1196

  You can track moods, thoughts, activities, and medicines that affect pain. Having a record of pain can help you and your doctor find the best ways to treat it. […] A support group can help you share your concerns and hear how other people cope with the pain and challenges of living with vulvodynia. […] Meditation and guided imagery are two examples of how you can reduce stress and relax your mind and muscles.

• #29 Vulvodynia (vulval pain, burning vulva)

  https://dermnetnz.org/topics/vulvodynia

  Vulvodynia generally occurs in adult women between the mid-’20s to late ’60s. […] Treatment of vulvodynia usually requires a multidisciplinary approach that may include: Medications, Physiotherapy, Psychological therapy, Pain management therapy, Behaviour modification, Surgery. […] Specific treatment of vulvodynia is described under each subtype. However, regardless of the type of vulvodynia, treatment for all must encompass a holistic approach taking into account the woman’s physical and psychological needs. […] Vulvodynia resolves spontaneously in about 40% of patients.

• #30 Vulvodynia: Pain Management Strategies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9781267/

  Therapeutic management consists of various types of options, including self-management, non-pharmacological therapies, pharmacological therapies and in some specific circumstances (vulvodynia unresponsive to medical therapy) even surgical therapies. […] In terms of specific treatments for vulvodynia, analgesic drugs are the best resource we have. The various drugs differ in their mode of action and administration. […] The various drugs differ in their mode of action and administration. […] Future studies are needed to draw up a unique therapeutic action plan that considers the stratification of patients with vulvodynia and the variability of the symptom. […] At present, the treatment of vulvodynia does not yet have a univocal consensus. Pharmacological therapy with analgesic drugs are widely used but are often not sufficient to counteract pain symptoms. It is often necessary to use combined strategies with the use of multiple drug classes associated with pelvic floor rehabilitation techniques and psychological support.

• #31 Vulvodynia – StatPearls – NCBI Bookshelf

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

  Topical medications applied directly to the vulva can help alleviate pain, provided they do not contain allergens. […] Women’s health physical therapy has become an effective component of vulvodynia treatment. Most patients should be referred for evaluation and management of pelvic floor muscle weakness and spasms. […] Nerve blocks, psychotherapy, mindfulness, yoga, and neurostimulation may also be beneficial in treatment. […] Surgery is generally reserved for cases of provoked vestibular vulvodynia and specific patients. Vaginal advancement involves removing the vestibule and the affected area of the vagina. Following the surgery, physical therapy and the use of dilators are recommended to support recovery. […] Early diagnosis and a multidisciplinary treatment approach can significantly improve outcomes. Although a universal cure does not exist, many patients achieve effective symptom management through a combination of medical, physical, and psychological therapies.

• #32 Vulvodynia – StatPearls – NCBI Bookshelf

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

  Addressing contributing factors such as nerve dysfunction or musculoskeletal issues can lead to long-term relief. Emotional and social support also play a vital role in enhancing quality of life. […] With appropriate care, many individuals experience reduced pain intensity and improved daily functioning.

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