Vulvar Pain
Vulvar pain, or vulvodynia, is chronic pain around the vaginal opening and surrounding tissues, lasting for more than three consecutive months. Symptoms can include burning, soreness, and painful intercourse, which can lead to emotional and sexual problems and a decreased quality of life.
What Is It?
Vulvodynia is derived from the combination of two words; “vulva” (the external genitalia in females) and Odyne, the Greek goddess of pain. The symptoms can make a woman so uncomfortable that sitting for long periods can be difficult and make vaginal penetration unthinkable. If you have vulvodynia do not let the absence of visible signs or embarrassment keep you from seeking treatment. The condition is further classified as being “provoked” or “unprovoked,” by stimuli and either localized or generalized. The localized areas can be the vestibule (vaginal opening / vestibulodynia), whereas generalized refers to diffuse vulvar pain, affecting the entire vulvar region.
Causes:
There can be many causes to vulvodynia; infections, inflammatory skin conditions, neurologic disorders, cancer, trauma, radiation, and hormonal imbalances.
Diagnosis:
Based on a targeted medical, sexual, psychological and surgical history and the determination of the location, nature, temporal pattern, extent, and duration of a woman’s symptoms, a diagnosis can be made. A pelvic examination should also be performed and possibly a sample from the cells in the vagina taken. A colposcopy (a magnified examination of the vulva) can be helpful. A cotton swab test is also necessary to gently check for specific, localized areas of pain in the vulvar area.
Treatment:
There are a variety of options available: medications, topical hormone therapy, green tea extract ointment, biofeedback, local injections of medication, pelvic physical therapy, and psychotherapy. It is important to seek out a doctor, such as myself, who is familiar with this condition in order to effectively treat based upon performing a thorough, directed herstory, hormonal testing and targeted physical examination.
At Zen Medical Care, treatment is aimed at women enjoying a healthy sexual life in midlife and beyond.
Vaginal Pain
What is It?
The common name for this is dyspareunia, or painful sexual intercourse. This condition affects half of postmenopausal women. Vaginal dryness progresses over time as mucous production lessens and the vaginal walls get thinner, a condition that is chronic unless treated. The symptoms may include pain only at sexual entry, pain with every penetration including sexual toys, fingers, etc., deep pain during thrusting, and throbbing pain lasting hours after penetration.
Causes:
When a woman goes through menopause, her estrogen and testosterone levels decrease, which can lead to the above-mentioned changes in the vagina, vulva and bladder. Causes for pain associated with this condition include lack of lubrication, lack of arousal, lack of sex hormones, narrowing and shortening of the vaginal opening and canal, vaginal infection(s), congenital abnormalities, and pelvic floor muscle tightening.
Diagnosis:
A medical evaluation should consist of a through medical, medication, and psychosocial history, visual examination of vagina, pelvic sonogram (if necessary) and sex hormone blood tests.
Treatment:
There are a number of effective treatments available such as topical hormones, lubricants, oral medication, laser therapy, vaginal relaxation exercises, sex therapy, pelvic floor physical therapy, and progressive vaginal dilators.
Dr. Enzenbacher does not settle for “blanket solutions,” rather she uses her unique mindset to find just the right solution for each of her clients, based on 35 years of dedicated care.
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