How is vulvodynia treated?

Vulvodynia treatment takes time. Finding the treatment or combination of treatments that will bring you relief from pain is a process of trial and error, and treatments that work might not work immediately.

Treatments you and your doctor might try include:

  • Topical medications: Creams and ointments containing anesthetics or nerve-stabilizing medications and are applied to the vulvar area. Sometimes these are used before sexual intercourse.
  • Oral medication: These medications can include antidepressants and anticonvulsants, to address nerve pain.
  • A nerve block: This is an injection of medication that interrupts the signals that send pain from nerves to the brain.
  • Physical therapy: Physical therapy is used for the treatment of vulvodynia, but not for muscle strengthening. This treatment is used for myofascial release. Muscles in the pelvic floor are often in spasm in women with vulvodynia. Working with a physical therapist trained in pelvic floor disorders can help to relax these muscles.
  • Vestibulectomy: This is a surgical procedure to remove tissue in the area where the patient feels pain. This can be helpful for women who have localized vulvodynia and haven’t been significantly helped by other treatments.
  • Counseling: This might be recommended, since vulvodynia can affect sexual relationships, self-esteem and overall quality of life.

What else can I do to relieve the pain of vulvodynia?

  • Avoid tight clothing and pantyhose.
  • Wear all-cotton underwear.
  • Use cold compresses or gel packs.
  • Avoid exercises that put pressure on the vulva, like cycling or horseback riding.
  • Wash the area gently with plain water. Don’t use soap in the genital area, don’t douche, and don’t use other possible irritants like deodorants or bubble bath.
  • Use a lubricant during sex, but stay away from the lubricants that are flavored or designed to create a cooling or warming sensation.
  • If you have to sit down for prolonged periods, it might help to sit on a foam “donut” or some other type of cushion that reduces pressure on the area of the vulva.
  • Reduce your stress levels and get adequate sleep.

Last reviewed by a Cleveland Clinic medical professional on 07/03/2018.

References

  • National Vulvodynia Association. What is Vulvodynia? Accessed 8/28/2018.
  • National Institutes of Health. Vulvodynia. Accessed 8/28/2018.
  • American Academy of Family Physicians. Vulvodynia. Accessed 8/28/2018.
  • The American College of Obstetricians and Gynecologists. Vulvodynia. Accessed 8/28/2018.
  • The American College of Obstetricians and Gynecologists. Colposcopy. Accessed 8/28/2018.
  • RadiologyInfo.org. Nerve Blocks. Accessed 8/28/2018.
  • Bornstein J, Goldstein A, Stockdale C. 2015 ISSVD, ISSWSH, and IPPS Consensus Terminology and Classification of Persistent Vulvar Pain and Vulvodynia. American Society for Colposcopy and Cervical Pathology. Journal of Lower Genital Tract Disease. April 2016;20(2):126-130. Accessed 8/28/2018.

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