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How is vulvodynia treated?

Andrea J. Rapkin, MD
OBGYN (Obstetrics & Gynecology)
Treatment of vulvodynia is often multimodal or multiplatform, as with any chronic pain condition. So it's not just one avenue that's taken for the treatment. The following are potential vulvodynia treatments:
  • removal of potential irritants
  • topical medications that can be applied to the painful area
  • physical therapy for the pelvic floor muscles
  • oral medications that are prescribed to alter nerve firing and get the nerves to go from the bad side back to the good side
  • cognitive-based therapies, including mindfulness approaches
  • surgery
Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)

The goal of pharmaceutical approaches to treating vulvodynia is to desensitize or block pain signals. Medications can be applied topically, directly on the vulva, taken orally, or injected.

Here are a few options that interrupt pain signals:

  • Topical anesthetics that contain lidocaine or capsaicin applied 30 minutes prior to activating      activity to numb affected area (avoid cortisone topical steroids)
  • Estradiol cream if estrogen is low
  • Antidepressant and  antiseizure medications that are known to have pain-reducing qualities
  • Trigger-point injections of steroids or Botox

Patients who see a physical therapist experienced in treating women with vulvodynia can see marked improvement in symptoms after a series of sessions. The therapist works on stabilizing muscle tone to improve contraction strength and structure of pelvic floor muscles, a potential trigger for pain.

Biofeedback, cognitive and behavioral therapies (CBT), and supportive talk psychotherapy can help patients develop self-regulation strategies to cope with the pain and psychosocial distress that can accompany a diagnosis.

As a last resort, surgical procedures (perineoplasty or vestibulectomy) remove tissue that is causing the pain.

Treatment involves removing any irritants and using gentle local care. Loose clothes and cold packs are helpful. Treatment may also include topical lidocaine (Xylocaine), tricyclic antidepressants, or anticonvulsants such as gabapentin.

Our Bodies, Ourselves: Menopause

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Our Bodies, Ourselves: Menopause

FROM THE EDITORS OF THE CLASSIC "BIBLE OF WOMEN'S HEALTH," A TRUSTWORTHY, UP-TO-DATE GUIDE TO HELP EVERY WOMAN NAVIGATE THE MENOPAUSE TRANSITION For decades, millions of women have relied on Our...

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.