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Treatments and drugs
By Mayo Clinic staffVulvodynia treatments focus on relieving symptoms. No one treatment works for every woman, and you may find that a combination of treatments works best for you. It may take weeks or even months for a new treatment regimen to noticeably improve your symptoms. Available options may include:
- Medications. Tricyclic antidepressants that may help lessen chronic pain include amitriptyline, desipramine (Norpramin) and nortriptyline (Aventyl, Pamelor). Anticonvulsants such as carbamazepine (Tegretol) and gabapentin (Neurontin) also may lessen the pain of vulvodynia. Antihistamines such as hydroxyzine can reduce itching.
- Biofeedback therapy. This therapy can help reduce pain by teaching you how to control specific body responses. The goal of biofeedback is to help you enter a relaxed state in order to decrease pain sensation. To cope with vulvodynia, biofeedback can teach you to relax your pelvic muscles, which can contract in anticipation of pain and actually cause chronic pain.
- Local anesthetics. Medications such as lidocaine ointment can provide temporary symptom relief. Your doctor may recommend applying lidocaine 30 minutes before sexual intercourse to reduce your discomfort. Your partner may also experience temporary numbness after sexual contact.
- Surgery. In cases where painful areas can be specifically pinpointed at the hymeneal ring (localized vulvodynia, vulvar vestibulitis), surgery to remove the affected skin and tissue (vestibulectomy) relieves pain in some women.
- Boardman LA, et al. Benign vulvovaginal disorders. In: Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:625.
- Stewart EG. Clinical manifestations and diagnosis of generalized vulvodynia. http://www.uptodate.com/home/index.html. Accessed May 18, 2009.
- Vulvodynia. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp127.cfm. Accessed April 1, 2009.
- Haefner HK, et al. The vulvodynia guideline. Journal of Lower Genital Tract Disease. 2005;9:40.
- Harlow BL, et al. A population-based assessment of chronic unexplained vulvar pain: Have we underestimated the prevalence of vulvodynia? Journal of the American Medical Women's Association. 2003;58:82.
- Stewart EG. Treatment of vulvar pain syndrome. http://www.uptodate.com/home/index.html. Accessed May 18, 2009.
- Self-help tips for vulvar skin care. National Vulvodynia Association. http://www.nva.org/patient_services/Self_Help_Tips.html. Accessed May 18, 2009.
