Vulvar pain affects women at all ages. It may be due the complexity of the clinical presentation and pathophysiology involved in vulvar pain due to a specific disorder or diagnosed as vulvodynia. Vulvodynia is defined as vulvar pain of at least 3 months' duration, without clear identifiable cause, which may have potential associated factors. The etiology of vulvodynia is still not exactly known, however many associated factors are acknowledged. These factors are among others: other pain syndromes (e.g., painful bladder syndrome, fibromyalgia, irritable bowel syndrome, temporomandibular disorder), Genetics, Hormonal factors (e.g., pharmacologically induced), Inflammatory, musculoskeletal (e.g., pelvic muscle overactivity, myofascial, biomechanical), Neurological, central and peripheral nervesystem affection, Psychosocial factors (e.g., mood, interpersonal, coping, role, sexual function), Structural defects (e.g., perineal descent).
The purpose of the presentation is to share knowledge on the various conservative treaments and the outcome on vulvar pain and vulvodynia.
Results from several studies all demonstrate that women with vulvodynia are significantly affected on all domains of their sexuality and report significantly higher levels of sexual distress compared to controls.Women with vulvar pain are also affected on dyadic parameters and psychological wellbeing.These results among many others imply that clinicians need to address the sexual functioning and level of sexual distress in women diagnosed with vulvodynia, and to consider psychosexual treatment as part of a multidisciplinary treatment program to reduce pain in the vulva.
As recommended by the International Society for the Study of Vulvovaginal Disease, International Society for the Study of Women's Sexual Health, and International Pelvic Pain Society, treatment on vulvar pain should be chosen according to the characteristics of the individual case and the possible associated factors, rather than as a “one-size-fits-all” approach. A multidisciplinary treatment approach is therefore recommended including conservative treament.
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2. Goldstein AT et al. Vulvodynia. Asessment and treatment. J Sex Med 2016 Apr;13(4):572-90
3. Thøfner LB et al. Multidisciplinary treatment on vulvodynia--where is the evidence?Ugeskr Laeger. 2014 Dec 22;176(52)