HBO's 'Sex and the City' touches on baffling condition > June 2001

In HBO's "Sex and the City," the shy Charlotte recently learned she could have vulvodynia, a condition that causes burning, stinging and itching in the genital area.

"Vulvo-what-ia?" her friend Carrie asks.

Until a few years ago, doctors might have asked the same question. But the baffling condition is getting increasing attention from the medical community.

About 60 articles on vulvodynia have appeared in medical journals during the past six months, and the National Institutes of Health recently funded four studies, said Chris Veasley of the National Vulvodynia Association.

Most doctors no longer dismiss the condition as a psychological ailment. Still, only about 20 percent of obstetrician-gynecologists know much about vulvodynia, said Dr. Ronald Meltzer, a obstetrician-gynecologist at Northwestern Memorial Hospital who specializes in vulvodynia.

No one knows how many women have vulvodynia, but the condition appears to be most common in white women. A survey of 400 women by a Harvard University researcher found that 8 percent of them suffered vulvodynia symptoms.

Vulvodynia (pronounced vul-vo-DIN-ee-a) is pain in the vulva, the external area around the vagina. Symptoms range from mild to severe, depending on the patient.

In some women, the pain is constant. In others it only hurts when pressure is applied. Symptoms usually begin suddenly, and can last for months or years.

"One day I was fine; the next day I wasn't," said the leader of a vulvodynia support group in Naperville, who has had the condition for 6 1/2 years.

She said vulvodynia feels like a combination of a bladder infection and a yeast infection. Sitting, urinating and wearing tight jeans are painful, and sex hurts so much she once went 10 months without having intercourse with her husband.

"Of all the pain I've ever had, this is the worst, because it interferes with every part of your life all day," she said.

Vulvodynia is diagnosed when other conditions, such as yeast or bacterial infections, have been ruled out. Tissue may appear swollen, or it may look normal. The cause is unknown.

Although there is no cure, there are several treatments. Anesthetic creams and ointments can provide temporary relief, for example, before intercourse. Low-dose tricyclic anti-depressants reduce chronic pain, even if the patient is not depressed. Surgery can remove small amounts of pain-sensitive tissue.

The June 3 episode of "Sex and the City" made light of vulvodynia. Charlotte's doctor assures her the condition is not serious. "It's mostly just uncomfortable," he says.

Vulvodynia association executive director Phyllis Mate said the show "failed miserably at portraying the serious and complicated nature of this condition."

An HBO spokeswoman declined comment.

On the Web: www.nva.org