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Treatments and drugs
By Mayo Clinic staffVulvodynia treatments focus on relieving symptoms. No one treatment works for every woman, and you may find that a combination of treatments works best for you. It may take weeks or even months for treatment to improve your symptoms noticeably. Options may include:
- Medications. Tricyclic antidepressants or anticonvulsants may help lessen chronic pain. Antihistamines may reduce itching.
- Biofeedback therapy. This therapy can help reduce pain by teaching you how to control specific body responses. The goal of biofeedback is to help you relax to decrease pain sensation. To cope with vulvodynia, biofeedback can teach you to relax your pelvic muscles, which can contract in anticipation of pain and actually cause chronic pain.
- Local anesthetics. Medications, such as lidocaine ointment, can provide temporary symptom relief. Your doctor may recommend applying lidocaine 30 minutes before sexual intercourse to reduce your discomfort. If you use lidocaine ointment, your partner also may experience temporary numbness after sexual contact.
- Nerve blocks. Women who have long-standing pain that doesn't respond to other treatments may benefit from local injections of nerve blocks.
- Pelvic floor therapy. Many women with vulvodynia have problems with the muscles of the pelvic floor, which supports the uterus, bladder and bowel. Exercises to strengthen those muscles may help relieve vulvodynia pain.
- Surgery. In cases in which painful areas can be specifically pinpointed at the hymeneal ring (localized vulvodynia, vulvar vestibulitis), surgery to remove the affected skin and tissue (vestibulectomy) relieves pain in some women.
References
- Stewart EG. Clinical manifestations and diagnosis of generalized vulvodynia. http://www.uptodate.com/home/index.html. Accessed April 21, 2011.
- Stewart EG. Treatment of vulvar pain syndrome. http://www.uptodate.com/home/index.html. Accessed April 21, 2011.
- Self-help tips for vulvar skin care. National Vulvodynia Association. http://www.nva.org/Self_Help_Tips.html. Accessed May 23, 2011.
- Vulvodynia. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp127.cfm. Accessed May 23, 2011.
- Kingdon J. Vulvodynia: A comprehensive review. Nursing for Women's Health. 2009;13:48.
- Groysman V. Vulvodynia: New concepts and review of the literature. Dermatological Clinics. 2010;28:681.
- Danby CS, et al. Approach to the diagnosis and treatment of vulvar pain. Dermatologic Therapy. 2010;23:485.
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