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Vulvodynia: A Painful Condition with Promising New Treatment Options - M

Vulvodynia: A Painful Condition with Promising New Treatment Options

Reviewed by Michael Hua, Pharm D
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Pain "down there" can be all-out anguishing. You may deal with discomfort with activities that should be enjoyable, whether that is intercourse with a partner or simply sitting. If you are one of the millions of women with vulvodynia, you may experience pain during sex, an irritating burning sensation, and vulvar pain that never seems to fully go away.

Vulvodynia may not come up in everyday conversations, but the problem is a very real, diagnosable condition. The first step to getting back your quality of life is determining what is happening with your most intimate areas and what may help. Let's take a closer look at vulvodynia, how to know if you may have this condition, the traditional treatments, and what promising supplements may help.

The general explanation of vulvodynia is chronic vulvar pain that may not have an identifiable cause. According to the American College of Obstetricians and Gynecologists (ACOG), vulvodynia can usually be diagnosed if you have vulvar pain that lasts longer than 90 days.

Vulvodynia may have no visible signs for some women, which can make the situation frustrating because you feel like something is wrong but don't see a problem. Diagnosis of vulvodynia usually involves a doctor performing a physical examination, doing tests, and examining your medical history. Several other conditions may have to be excluded, such as sexual or pelvic floor dysfunction, as your gynecologist works to make the proper diagnosis.

Even though many women are hesitant to discuss their symptoms with their doctor, vulvodynia may be more common than expected. Some research efforts have stated that the condition may affect as much as 16 percent of women. Chronic vulvar pain is so common that it is suspected to affect women of every age group and ethnicity.

Vulvodynia doesn't always have a clear identifiable cause. Unfortunately, this can make obtaining the proper diagnosis difficult. What researchers do know is vulvodynia can be associated with certain issues. For example, you may be more prone to vulvodynia if you have experienced:

  • Past vaginal-area infections
  • Hormonal fluctuations or changes
  • Irritation of vulvar nerves
  • Pelvic floor spasms of weakness

In addition, vulvodynia can be associated with certain co-morbid conditions, such as:

  • Fibromyalgia
  • Irritable Bowel Syndrome
  • Chronic fatigue syndrome
  • Depression
  • PTSD

The usual assessment for vulvodynia will include testing for infections, physical examination of vulvar anatomy and to look for pelvic floor dysfunction, and possibly tests for vaginal pH levels.

Vulvodynia can be characterized by a list of types of vulvar pain or discomforts, such as:

  • A burning sensation
  • Painful intercourse (dyspareunia)
  • Vulvar irritation and redness or feeling "raw"
  • Vulvar throbbing or stinging
  • Vulvar itching for months or prolonged periods of time

Some women experience discomfort occasionally, while some women may have constant vulvar pain. The pain can also be more localized to certain spots or more generalized in nature and seem to affect the entire vulvar area. Vulvar pain, oddly enough, can sometimes even present itself as pain in other parts of the body, such as the back or hips.

In the most severe cases, vulvar pain can be so intense that even everyday activities like sitting can be uncomfortable. Pain during sex can also get worse with time, due to burning sensations or inflammation that may worsen after intercourse. If you are experiencing any of these symptoms, opening up to your doctor about what is taking place may lead to much-needed relief with the proper treatment.

Vulvodynia may be common, but without a single known cause for most women, the condition can be notoriously difficult to treat. The majority of treatments involve medications, lifestyle-change recommendations, and other options in an effort to reduce vulvar pain, restore sexual function, and hopefully improve your quality of life. Believe it or not, only a handful of formal studies on vulvodynia treatment have been completed. Nevertheless, quite a few treatments do seem to help with the symptoms on some level.

Oral medications may be prescribed to help deter the symptoms of vulvodynia. For example, you may be prescribed an antihistamine to deter vulvar itching or pain medication to help with the pain. As an example, oral amitriptyline is often given for pain control, but the medication can come along with side effects like depression, dizziness, constipation, and even risks of withdrawal with prolonged use.

A topical treatment containing a combination of baclofen and palmitoylethanolamide (PEA) was examined in 2014 as a potential treatment for vulvar pain. One patient with severe vulvar pain saw a 50 percent decrease in symptoms and was able to enjoy sex again without pain after several months of treatment with the topical combination medication. As a side, note, topical cream with baclofen and PEA is only available through a compounding pharmacy because the combination of the pharmaceutical and supplement are not manufactured as a commercial product.

An alternative vulvodynia treatment with over-the-counter palmitoylethanolamide is proving to be a promising option for women. While prescription remedies may help with vulvar pain, burning sensations, and possibly painful intercourse, many prescription remedies have undesirable side effects and limited effectiveness. PEA supplements, on the other hand, are generally free of unwanted side effects and can be quite effective for some women. Even more attractive, PEA supplements are available over the counter without a prescription.

In general terms, PEA is actually a fatty molecule that is produced naturally by the body. However, the molecule can also be found in some plants and animals. Therefore, the supplements are easy enough to create by extracting the molecule from food sources like eggs, soybeans, certain types of meat, and peanuts.

In the body, PEA plays a role in a number of functions associated with pain and inflammation. If natural PEA is lacking, which can be the case for people with certain medical conditions, supplementing with over-the-counter supplements may help with certain conditions. The molecule has actually been shown to have prominent anti-inflammatory properties that can help with chronic pain, neuropathic pain, or inflammation.

Even though the underlying cause of vulvodynia or chronic vulvar pain is not always known, many researchers suspect neuropathic pain or even inflammation could be major culprits. The natural properties of PEA could potentially regulate networks that are in direct control of pain and inflammation. Therefore, PEA supplementation may help deter some symptoms you may experience with vulvodynia.

Thanks to the latest studies, theories about the effectiveness of PEA for vulvar pain are now more readily accepted as fact. The supplement has been proven to have noteworthy benefits for people with different types of chronic pain. One of the more noteworthy case studies involved a female who had experienced vaginal and vulvar discomfort for 25 years. She was given oral PEA supplements and topical PEA gel and saw immediate relief of pain and itching the next day.

Vulvar pain may be a bit hard to talk about, but you are definitely not alone with your problem. So many women have found relief through medications for symptom relief and over-the-counter alternatives like PEA supplements. Your vulvar pain should not impede your ability to live a normal life, especially when we are available to help.

To make sure you get the highest quality PEA supplements or for help obtaining the proper prescription, reach out to us at Harbor Compounding Pharmacy. We can provide the best supplements that have been properly tested for quality and formulation. Our pharmacy is PCAB-accredited and serves clients across numerous locations in Indiana, New York, Washington, Colorado, Pennsylvania, California, and Las Vegas.

Learn more about your treatment options:

Baclofen 5% Topical Cream & PEA Supplements

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References

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