Dr. Margaret Whitney, UT Health
What is Vulvodynia and what are the risk factors?
Vulvodynia is a condition in which women experience pain on the vulva, which is the area outside the vagina between the mons pubis and the anus. It can include the labia, clitoris, vaginal opening and other areas. Some women have constant pain, while others may only have pain when provoked by certain activities, such as sex or wearing tight clothing. It is generally considered to be a chronic condition, but many women have resolution of their symptoms with appropriate therapy, and relapse varies from person to person. Known risk factors include young age, Hispanic ethnicity, being married and having coexisting conditions such as depression, post-traumatic stress disorder, sleep dysfunction and other pain syndromes like irritable bowel or bladder-pain syndromes and fibromyalgia. However, this is an area of medicine that is poorly understood and there are likely other risk factors and associated conditions that we have yet to identify.
How many women are affected by vulvodynia and at what age does it affect women?
Surveys suggest 3 to 16 percent of women report pain suggestive of vulvodynia. It is more common in younger women but can occur in women of all ages, such as during the time of menopause. Vulvodynia can occur early in life, such as with the first tampon use, and it can occur later in life after a pain-free period.
Why is it important to treat vulvodynia?
Many women with vulvodynia have seen multiple medical providers before they are given a diagnosis of vulvodynia, and even fewer can find effective treatment. The condition can have a significant impact on self-esteem, relationships, quality of life and ability to work. There is still much to be learned about this condition, and by treating more women, we can begin to learn more about the disease and hope to continue to offer better and more effective treatment options.
What aspect of vulvodynia do patients struggle with the most?
Many of our patients have been told there is nothing wrong or have been misdiagnosed. This seems to be a common hardship many have endured. They often feel they have been disregarded and not heard.
What treatment options are available?
Treatment can vary depending on the severity, duration and associated conditions. There can be an initial period of trial and error, and most women benefit from a multidisciplinary approach to care
How does Women’s Health Institute use the team approach for patients with vulvodynia?
We approach vulvodynia using the biopsychosocial model of care. This means we treat the whole person and keep in mind the complex issues that can arise when a patient is living with a painful condition. Our team includes associate providers, such as physician assistants and nurse practitioners, pelvic-floor physical therapists, sex counselors, social workers and behavioral health specialists, nutritionists and physicians. All members of the team play a critical role in the treatment of our patients. We meet as a team in the morning to review patient treatment plans so we can receive input from all team members.
What is one thing you want women to know who are suffering from vulvodynia?
We can help you. We can help you live with your symptoms to help you manage them and hopefully improve them.
Dr. Margaret Whitney is a gynecologist at the UT Health Austin Women’s Health Institute. The institute focuses specifically on complex women’s pelvic conditions, such as urinary incontinence, pelvic-floor disorders and vulvar disorders.
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