Vulvodynia Case Studies

Decent Essays
Chronic pain is estimated to affect approximately
18% of adult Australians.6 Symptoms are frequently localised to a particular part of the body (eg vulvodynia, irritable bowel syndrome or chronic low back pain) but can be generalised (eg fibromyalgia). Whatever the location or distribution of pain, it is now thought there is a common central pathology, which helps explain frequently observed comorbid symptoms of multifocal pain, fatigue, sleep disturbance and mood changes.7 There is increased incidence of co-existent pain disorders and women with vulvodynia have a 2–3-fold increase in the likelihood of having another pain condition.8
It is not understood why some individuals develop chronic pain and others do not. It seems that some individuals experience
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There are localised neuroinflammatory changes within the mucosa, including increased concentration of pro-inflammatory peptides and hyperinnervation with C-fibres.11
These fibres are multimodal sensory fibres that, when stimulated, can result in prolonged burning. In addition, there is hypertonicity of the pelvic floor muscles, resulting in introital narrowing and muscle pain.
Vulvar discomfort is often described as burning or raw, but also stinging, tearing, stabbing or itchy. In the absence of touch or pressure, women are often symptom-free. Typically, pain is provoked by sexual intercourse, use of tampons and tight clothing.
Pain or burning characteristically continues after intercourse, often lasting a few hours but sometimes several days (after sensation).
Pain may be so severe as to preclude sexual intercourse.
LPV is divided into primary or secondary, depending on whether the pain arose before or after first sexual intercourse.
This is an important separation because primary LPV can be more difficult to treat and secondary LPV may be associated
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