It has been described as a constant throbbing, or sometimes a burning, searing raw irritation that extends anywhere from the outside of the vulva clear to the inside of the vagina -and even down to the thighs and the lower body.
For some women it is most intense when pressure is applied - during intercourse, for example, or when inserting a tampon . For others, simply wearing slacks or tight fitting underwear sends shock waves through their entire pelvic region.
The problem is medically known as vulvodynia, a unique form of vulvar pain that is said to affect at least 15% of all women, mostly beginning around age 25.
According to the International Society for the Study of Vulvovaginal Disease (ISSVD) Vulvodynia is considered a chronic discomfort or pain, for which there is no infection or skin disease of the vulva or vagina causing these symptoms. Burning sensations are the most common, but the type and severity of symptoms are highly individualized. Pain may be constant or intermittent, localized or diffuse.
Vulvodynia has been classified into the following subtypes:
Dysesthetic Vulvodynia (generalized vulvar dysesthesia)
Symptoms may be diffuse or in different areas at different times. Pain may be present in the labia majora, labia minora, and/or the vestibule. (see vulvar anatomy) Some women experience pain in the clitoris, mons pubis, perineum and/or the inner thighs. The pain may be constant or intermittent.
Symptoms are not necessarily caused by touch or pressure to the vulva, i.e., with intercourse or bicycle riding, but these activities often exacerbate the symptoms.
Vulvar Vestibulitis Syndrome (vulvar dysesthesia localized in the vestibule)
Women with VVS have pain only in the vestibule, and only during or after touch or pressure is applied. Burning sensations are the most common symptom and may be experienced with some or all of the following: sexual intercourse, tampon insertion, gynecologic examination, bicycle riding, and wearing tight pants.
There are several other conditions that cause chronic vulvar pain and may coexist with Vulvodynia. The most common of these are :
Cyclic Vulvovaginitis
Women with cyclic vulvovaginitis have recurrent burning and itching symptoms at the same stage of the menstrual cycle. Many have cyclical bouts of yeast infections and some have other causes for their symptoms.
Vulvar Dermatoses
There are many dermatologic conditions that may cause pain in the vulva. The most common include: allergic or contact dermatitis, lichen sclerosus, lichen simplex chronicus and lichen planus. These conditions may cause symptoms of itching and burning. Scratching the vulva and overusing topical medications may inflame the tissue, causing swelling and additional pain.
Vulvodynia, as with most chronic pain conditions, can have a profound impact on a woman's quality of life. It typically affects her ability to engage in sexual activity and may interfere with daily functioning, e.g., sitting at a desk, engaging in physical exercise, and participating in social activities. These limitations can negatively affect self-image and lead to depression.
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