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Finding Relief From Vulva Pain

At least 200,000 American women suffer from chronic vulva pain, a condition that perplexes doctors and can destroy a woman's sex life.

No "One-Size-Fits-All" Treatment continued...

She advises patients to eliminate sources of irritation, such as tight jeans or horseback riding, and to soothe the vulva with an ice pack or fan and possibly a topical anesthetic such as Xylocaine. Any condition that might be causing vulvodynia is treated. She uses tricyclic antidepressants and anticonvulsants to control pain.

She also sends patients to a physical therapist who understands vulvodynia and can detect old injuries or poorly aligned muscles and treat muscle spasms. "My experience is we can help most people, especially if we see them early enough," says Stewart. "I do have patients whose pain I haven't been able to improve, and I've sent some to pain clinics."

Vestibulectomy is a surgical option that removes sensitive nerve endings but should be considered only as a last resort, says Stewart. Conservative medical therapy is the initial treatment of choice. "Get another opinion. It's very helpful for properly selected women, but usually we try medical things first."

Don't Give Up Sex

Pain destroys sexual desire and can also lead to the fear of sex because of the chronic pain.Many women give up sex altogether, depriving themselves of pleasure and putting relationships at risk. The pain from vulvodynia can also lead to spasm of the muscles around the vagina making sex penetration harder for a woman's partner. "Many husbands and partners are very understanding, but sometimes you see marriages break up," says Stewart. "Vulvodynia really can wreck your life."

She and Stewart encourage women to engage in nonpenetrative sex. "For most patients, the clitoris doesn't hurt," says Glazer, who prefers to see patients accompanied by their partners. "They can still remain quite intimate by doing oral sex."

Where To Find Help

"If a woman's gynecologist doesn't know about this stuff, she needs to get on the phone and find the most savvy person she can. Call a doctor's office and ask the nurse if they see a lot of vulvar problems and if they know what vulvodynia is. Sometimes university medical settings have fairly sophisticated care."

"Getting adequate diagnosis and treatment is very hard in face of the lack of education and the overwhelming mystique that it's in women's heads," says Stewart. "You have to take charge of your own health in order to get treatment."

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