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The International Society for the Study of Vulvovaginal Disease
(ISSVD) defines Vulvodynia as chronic vulvar discomfort or pain,
characterized by burning, stinging, irritation or rawness of the
female genitalia in cases in which there is no infection or skin
disease of the vulva or vagina causing these symptoms. Burning sensations
are the most common, but the type and severity of symptoms are highly
individualized. Pain may be constant or intermittent, localized
or diffuse.
Vulvodynia has been classified into the following subtypes:
Generalized (or dysesthetic) Vulvodynia
Generalized Vulvodynia symptoms may be diffuse or in different
areas at different times. Pain may be present in the labia majora,
labia minora, and/or the vestibule. (see
vulvar anatomy) Some women experience pain in the clitoris,
mons pubis, perineum and/or the inner thighs. The pain may be
constant or intermittent. Symptoms are not necessarily caused
by touch or pressure to the vulva, i.e., with intercourse or bicycle
riding, but these activities often exacerbate the symptoms.
Vulvar Vestibulitis Syndrome (also known as vestibulodynia)
Women with VVS have pain only in the vestibule, and only during
or after touch or pressure is applied. Burning sensations are
the most common symptom and may be experienced with some or all
of the following: sexual intercourse, tampon insertion, gynecologic
examination, bicycle riding, and wearing tight pants.
There are several other conditions that cause chronic vulvar pain
and may coexist with Vulvodynia. The most common of these are listed
below:
Cyclic Vulvovaginitis
Women with cyclic vulvovaginitis have recurrent burning and itching
symptoms at the same stage of the menstrual cycle. Many have cyclical
bouts of yeast infections and some have other causes for their
symptoms.
Vulvar Dermatoses
There are many dermatologic conditions that may cause pain in
the vulva. The most common include: allergic or contact dermatitis,
lichen sclerosus, lichen simplex chronicus and lichen planus.
These conditions may cause symptoms of itching and burning. Scratching
the vulva and overusing topical medications may inflame the tissue,
causing swelling and additional pain.
Vulvodynia, as with most chronic pain conditions, can have a profound
impact on a woman’s quality of life. It typically affects her
ability to engage in sexual activity and may interfere with daily
functioning, e.g., sitting at a desk, engaging in physical exercise,
and participating in social activities. These limitations can negatively
affect self-image and lead to depression.
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