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What causes vulvodynia?

Dr. Andrea J. Rapkin, MD
OBGYN (Obstetrician & Gynecologist)

Doctors don't exactly know what causes vulvodynia, and likely there is more than one cause. Some possible contributing factors supported by research include an increased number of little nerve endings in the vulvar tissue, particularly in the vestibule, and changes in the hormones (estrogens and androgens) or hormone receptors in the tissues. Increased inflammatory secretions in the tissues could also be a contributing factor. Increased numbers of inflammatory cells and some mediators of inflammation have been found in the vestibular tissue of women with vulvodynia.

The pelvic floor muscles that line the vagina and hold everything up may be weak, but more interestingly, spasm, or a tenderness or inappropriate tightness and contraction, is something that can be very problematic in this disorder. There are also many studies showing changes in the brain processing of pain signals from the vaginal area.

The most offending irritants that may increase the likelihood of vulvodynia are usually soaps, such as colored or scented soaps; strong detergents; fabric softeners (even those fabric softener sheets that go in the dryer); certain lubricants that are not scent free; and bubble baths and bath oils.

In treating vulvodynia, your doctor may recommend removing all irritants. Even if you have used a particular brand of soap for years, it can suddenly become irritating. Just because you have been using a particular product doesn't mean you can't now have developed a contact dermatitis-like situation or that the tissue is not becoming more sensitive to the product you're using.

We suggest you wear comfortable cotton underwear. Panty liners are very often used for sanitary protection during menstruation, but it may not be a good idea to wear them every day as they are very irritating. You will also need to avoid potential mechanical trauma, such as tight-fitting jeans and so on.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

The pain of vulvodynia can occur unprovoked or it can be triggered by direct contact. It can be constant or intermittent, mild or excruciating, and it can last for 6 months or longer. Childbirth, physical trauma, past surgery, scarring, and certain neurological conditions are known to activate vulvodynia.

The actual cause has eluded researchers but a genetic, hormonal, muscular, or neurological component that causes nerves to become overstimulated, overabundant, or entangled has been proposed. Some researchers have suggested that whatever is at work with fibromyalgia or chronic fatigue syndrome is at work here, causing intense and frequent firing of nerve signals.

Although it is not caused by infection or sexually transmitted diseases, people with vulvodynia may have a reaction that heightens the response to irritants like infections that produce an overload of immune chemicals to affect nerve function.

Watch as Dr. Jennifer Ashton and Dr. Oz discuss the other causes of vulvodynia in this video.

This content originally appeared on doctoroz.com.

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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.