Vulvodynia is the most common cause of painful intercourse. Vulvodynia is defined as ”vulvar discomfort”, most often described as burning pain, occurring in the absence of relevant and visible findings or specific, clinically identifiable, neurological disorder. In addition to reports of burning, patients often speak of rawness, stabbing, stinging or tightness. The pain can vary in intensity and can affect the entire vulvar area or be localized to the vestibule, perineum or clitoris. When provoked by intercourse, pain can disrupt sexual activity, give rise to fear, loss of sexual desire and ultimately lead to abstinence. Because Vulvodynia is a diagnosis of exclusion, the absence of any known medical or neurological cause leaves the sufferer without a reason for the pain and no effective options for treatment.
Vulvodynia affects women of all ages but its occurrence peaks in early adulthood.
Age Specific Incidence of Vulvodynia.
Some women report an early onset of symptoms, occurring prior to commencement of sexual activity (primary Vulvodynia), while others experience onset following a period of pain free sexual activity (secondary Vulvodynia). In some instances the onset of pain follows prolonged periods of thrush infections, skin problems or surgical procedures, while in others no specific trigger can be identified. Vulvodynia causes significant personal distress, affecting a women’s perception of her body, her confidence and self-esteem.
Patients who suffer from Vulvodynia can also suffer from bladder pain, rectal pain as well as coexisting problems such as inflammatory bowel Syndrome (IBS), skin sensitivities and allergies, chronic muscle tension, premenstrual syndrome symptoms, chronic fatigue and Fibromyalgia.
The chronic and disabling nature of urogential pain impacts relationships and the psychological well-being of women. As a result a large percentage of sufferers present with depressed affect and elevated anxiety. Psychological reactions to pain can affect the quality of life equally as much as the sensory aspects. Therapy needs to address emotional distress, anxiety and depression as well as other coexisting physical problems.
Female Sexual Pain
Female Sexual Pain Disorders and Chronic Pelvic Pain include a group of problems in which one of the primary complaints is pain during sexual intercourse. The prevalence of these disorders is underestimated; they are frequently misdiagnosed and ineffectively managed. Sufferers often feel isolated and are embarrassed to discuss their pain with health care providers, yet evidence shows that between 20% and 40% if women report experiencing some form of pain with intercourse during their lifetime. The severity of pain varies but may disrupt daily activities, preclude sexual intimacy, impact relationships and significantly compromise quality of life. Chronic pain of this nature exacts a high personal cost and leads to distress and worry.