What are the common symptoms of Vulvodynia?
Vulvodynia is a descriptive term which refers to pain in the vulvar area. When asked to describe their pain patients commonly used the following descriptors; burning, itching, dryness, rawness and a drawing sensation.
The symptoms may range from mild to severe. Some women may have occasional discomfort, while others are uncomfortable on a daily basis and find it difficult to sit or walk. Some may tolerate sexual intercourse, while others may experience severe pain during or post intercourse. Some patients are so incapacitated by the pain that they may abstain from intercourse, avoid using tampons, wearing slacks or any type of tight clothing.
When asked to identify the location of the pain the following sites were most commonly identified:
Patients can report pain in multiple sites or in a single focal area.
It is not uncommon for patients to report other commonly coexisting conditions. The most common disorders reported by vulvodynia patients include:
Who gets Vulvodynia?
Contrary to earlier perceptions that vulvodynia predominantly affected Caucasian women of fair complexions, white and African American women reported a similar lifetime prevalence of the disorder.
A recent clinical study of 744 Australian women, diagnosed with vulvodynia, examined the age distribution of patients and studied the age of symptom onset (Jantos 2007). The study found that 75% of the vulvodynia patients were under the age of 34 years. Prevalence peaked at 24 years of age.
The average age of symptom onset was 22.8 years, but for primary vulvodynia cases (early onset) the average age of onset was 19 years of age. The age of onset ranged from 5.5 years to 45.2 years. The onset of symptoms occurred before the age of 24 years in approximately 50% of the case. The age related risk of symptom onset coincided with a time when many young women were entering into closer relationships.
An unexpected finding in the Australian study was that a significant number of the women reported the onset of symptoms in their early childhood or shortly after puberty, with commencement of tampon use, first medical exam, or with first attempts at sexual activity. These findings, for the first time, highlight the very early onset of symptoms for at least half of the vulvodynia patient group. These findings were initially met with a degree of scepticism but a later retrospective study of vulvodynia in preadolescent girls confirmed the occurrence of vulvodynia in children between ages four to eleven, with duration of pain varying from several months to seven years (Reed & Cantor, 2008).
From these findings it is evident that vulvodynia can affect girls and women of any age. The triggers and risk factors for such an early onset are not clear, but most likely are multi-factorial.
What causes Vulvodynia?
A range of causes of vulvodynia has been proposed, immunological, genetic, hormonal, inflammatory, infectious and neuropathic (Haefner et al., 2005). It is unlikely that there is one single cause for vulvodynia. One of the common reported triggers that may lead to vulvodynia is the presence of chronic thrush. Thrush may be a potential trigger of inflammatory reactions leading to sensitization but many other triggers are known to play an important role.
For a more detailed discussion of the search for causes of vulvodynia refer to articles by Marek Jantos on research linking organic, physiological and psychological factors with vulvodynia.