Vulvodynia in Health magazine

[mshopgirl]

I was catching up on the latest Health magazine (May 2012) & couldn’t help but notice the very brief discussion of vulvodynia in the Live Health Q&A section. After reading it, I am not surprised that women have trouble finding help and treatment for vaginal pain!

(I couldn’t find a copy of the article online, so I transcribed it below.)

Q: I sometimes feel a stabbing pain down there. What could be causing it?
A: Remember when Charlotte’s vagina was “depressed” on “Sex and the City”? She had this problem – specifically, chronic vulvar pain, also known as vulvodynia. It’s characterized by soreness, burning, or itching in the vulva, and symptoms can appear or disappear without any apparent trigger (though you may feel them during sex or even long bouts of sitting). Not much is known about the causes, but there are several treatment options: antidepressants (which can affect your perception of pain), biofeedback (to help relax the pelvic muscles), topical creams, or, in some cases, surgery (to remove tissue involved with the condition).

While I appreciate that vulvodynia is being discussed and shared in a magazine media, I cringe at the idea that this is the medical advice that women with a very serious problem are receiving. Perhaps it is a no-brainer, but there is not even a mention of seeing an OB/GYN or any sort of specialist.

Thoughts?

[Dr. Pacik]

It is not any different in the scientific literature. Vulvodynia is usually the “default” diagnosis of sexual pain and most of the time vaginismus is not mentioned.
The “Q tip test” to determine if a woman has vulvodynia is generally done incorrectly. Any reaction of the patient to this testing automatically calls for a diagnosis of vulvodynia, when in fact no effort is made to separate anxiety from actual pain. Some women have difficulty differentiating anxiety from pain when tested in an area of great concern. Fully half my patients test “positive” for vulvodynia, yet only one patient had true associated vulvodynia. The rest all got better once they started having intercourse. This is why it is so important to help advocate about the truth behind vaginismus. It is under-diagnosed and misunderstood by both the lay public and health care professionals. This is why it is important to tell ‘Your Story” to anyone in the media willing to listen.
Vaginismus is NOT vulvodynia.

[Heather34]

Hi mshopgirl and Dr. Pacik. Thank you for posting about this article and I, too, agree that more needs to be done to educate physicians on the condition of vaginismus as to prevent the automatic “catch-all” diagnosis of vulvodynia. I actually was misdiagnosed with vulvodynia because of the difficulty Dr. Pacik described (i.e. differentiating anxiety from pain). I explained to my GYN doctor that I had researched about the condition of vaginismus and described my symptoms in detail. Despite this, she automatically dismissed what I said and diagnosed me with vulvodynia. Within 1 week of my Botox treatment for VAGINISMUS (not vulvodynia), I was cured and my husband and I were able to have pain-free intercourse for the first time. I couldn’t agree more that it’s very important to share our stories with the media as to educate physicians and clinicians on the correct diagnosis of vaginismus.