Written by: Nicole Snowball
Many women with vulvo-vaginal pain have seen numerous medical professionals, yet still do not feel as though they really know what their pain is, or what causes it. Below you can find answers to some frequently asked questions about vulvo-vaginal pain. Read Part 1 of this FAQ here.
How is PVD diagnosed?
PVD is most often diagnosed by a gynaecologist. During a gynaecological appointment, a health provider will likely take a medical history, ask questions regarding your pain symptoms, and do a physical examination. The physical exam typically includes:
- A visual inspection of the vulva
- An examination of the vagina and uterus using one finger
- An assessment of pain through a cotton-swab test
How is PVD treated?
Though no treatment currently exists that completely “cures” PVD, many health professionals suggest a multi-disciplinary approach to managing PVD. These various approaches in combination are often effective for PVD:
- Discontinuing the use of irritants (e.g., fabric softener, synthetic fabrics, or scented products that come into contact with the vulvar region)
- Topical medications to block the pain
- Oral medications to block the pain
- Pelvic floor physiotherapy
- Group, couple, or individual cognitive-behavioural therapy
- Surgical procedures
No one can see any physical evidence of a condition, but I still feel pain. Is it all in my head?
NO! The pain is definitely not all in your head. Just because health providers cannot identify a physical problem – like a structural difference, or an infection – does not mean that your pain is not real or that you are imagining it!
As a comparison: would we tell someone with anxiety problems that just because we cannot physically find the anxiety in their brain that their anxiety is not real? No! We know that anxiety is a very real experience, whether we can locate it in the brain or not, and we know this for PVD as well.
Why did it take so long for me to get a diagnosis?
Research in the field of vulvo-vaginal pain is still quite new, so many health professionals are not yet fully informed about PVD. Additionally, talking about vulvo-vaginal pain can be uncomfortable or difficult for both patients and health professionals. The best way to get the help you need for your PVD is to become informed and talk to your health care provider about the information that you learn.
Where can I find more information on PVD?
Read Part 1 of this FAQ.
Here are a few good websites focused on vulvodynia:
Bergeron, S., Binik, Y. M., Khalifé, S., Pagidas, K., & Glazer, H. I. (2001). Vulvar vestibulitis syndrome: Reliability of diagnosis and evaluation of current diagnostic criteria. Obstetrics & Gynecology, 98, 45-51.
Bergeron, S., Corsini-Munt, S., Aerts, L., Rancourt, K., & Rosen, N. O. (2015). Female sexual pain disorders: A review of the literature on etiology and treatment. Current Sexual Health Reports, 1-11.
Harlow, B. L., Kunitz, C. G., Nguyen, R. H., Rydell, S. A., Turner, R. M., & MacLehose, R. F. (2014). Prevalence of symptoms consistent with a diagnosis of vulvodynia: Population-based estimates from 2 geographic regions. American Journal of Obstetrics and Gynecology, 210, 40.e1-40.e8.
Harlow, B. L., & Stewart, E. G. (2002). A population-based assessment of chronic unexplained vulvar pain: Have we underestimated the prevalence of vulvodynia?. Journal of the American Medical Women’s Association (1972), 58(2), 82-88.
National Vulvodynia Assocation (n.d.). Retrieved November 27, 2015 from: www.nva.org