VULVODYNIA
(VVS)
Refers to an inflammation of the tissues surrounding the opening of the vagina. Symptoms may include: burning around the vaginal opening, pelvic and/or vaginal pain, painful intercourse, pain upon insertion of a tampon, and painful urination. Affected tissues are usually reddened. The cause is usually unknown; some theories include: allergic drug reactions, over treatment of chronic yeast infections, chemical reactions to soaps/detergents. VVS may also be caused by compression of pudendal nerve, which supplies the genital area.
(LAS)
A condition in which the muscles of the pelvic floor, which create a sling-like support to the vagina, rectum and bladder, are in a state of chronic spasm and tightness. This usually occurs in conjunction with a condition such as VVS, as a result of vulvar pain. The muscle tightness creates a poor healing environment for the vaginal tissues, because circulation is compromised as in any painful muscle guarding condition. Treatment of LAS is an essential component of the treatment of many pelvic and vaginal pain syndromes.
The purpose of this web site is to help spread awareness and provide women suffering from this condition with a source of information.
For six years I suffered with vulvodynia. I visited over twenty doctors and tried every therapy I could possibly find in western medicine and eastern medicine. The most frustrating part of my experience was dealing with a lack of awareness within the medical community. My pain was not validated by doctors for many years. On more than one occasion, I was told that absolutely nothing was wrong with me. Some other comments made by medical professionals were:
· Go home and drink a glass of wine
· I see nothing wrong with you; maybe it is stress
· The pain is psychosomatic
· Are you in a bad relationship
· Maybe this is due to an unresolved issue from a past life
This mostly unseen condition can have a tremendous affect on one's daily life. It affects your daily comfort level, your relationships, and your view of yourself as a woman. It is mentally straining to experience pain everyday of one's life. The clothes one chooses to wear, as well as the positions one can sit in all contribute to the level of pain one will experience. A woman's sexuality is limited due to pain during intercourse. This condition requires some kind of support network such as an understanding partner, close friends and knowledgeable medical personnel. I applaud those within the medical community who put the time and energy into researching vulvodynia and treating women with this condition.
I want to share with you the therapies I have tried over the past six years.
· medications: elavil, amitriptyline, claritin
· lidocaine
· sitz baths with domeboro and various herbs
· low oxolate diet
· interferon shots
· a temporary nerve block
· acupuncture
· spinal cord stimulator implant
· herbs
· biofeedback
· reflexology
· massage
· physical therapy of pelvic floor muscles
· freezing of inflamed cervical cells (cryosurgery)
· surgery to remove vestibular glands
It was not until this year (2001) that I began therapy at Johns Hopkins Hospital and began to experience some relief. For six months, I underwent physical therapy to reduce muscle tension of the pelvic floor muscles. The cells on my cervix were frozen off to reduce the inflammation. Also, I had surgery in order to remove my lower vestibular glands and to reposition some of the irritated tissue. I can happily say my pain is vanishing :)
I highly recommend to any woman that suspects she may be suffering from vulvodynia to contact the women's physical therapy department at Johns Hopkins Hospital at
(410) 955-0015 or email Megan Small (PT) at megsmall@jhmi.edu. You may also contact Kamal Alexander Hamod, M.D., M.P.H., P.A. at (410) 847-3500. Or visit http://www.med.jhu.edu/rehab/services/women.html. Please start your search for healing where I ended mine !
The following statement was adopted by the executive committee of the Section on Obstetrics and Gynecology (now the Section on Women's Health) San Antonio, TX, February, 1993: "Internal examination of the pelvic floor muscles is consistent with physical therapy practice. It complies with national physical therapy policies requiring the performance of test measurements of neuromuscular function as an aid to the evaluation and treatment of a specific medical condition".
There are over 2500 physical therapists in the United States trained in treating women's health diagnoses. At the Johns Hopkins Hospital, there are 7 such therapists. Common diagnoses that we treat through physical therapy measures include: chronic pelvic pain, vulvodynia (pain in the vaginal area), vaginismus, coccydynia (pain in the anus or tailbone), dyspareunia (pain with intercourse), urinary incontinence, post-surgical dysfunction and pain related to hysterectomy, mastectomy, breast surgery, pelvic floor muscle and bladder surgery.
All physical therapists are trained to evaluate and treat a wide range of musculoskeletal disorders. The gynecological physical therapist has this background, but also chooses to specialize in the area of women's health. We use a variety of physical therapy measures to restore normal pelvic floor muscular control and tone. For those with pelvic floor muscle dysfunction, we offer: vaginal or rectal electrical stimulation, pelvic floor and associated hip musculature massage and manual techniques, vaginal and rectal biofeedback, vaginal or rectal weights, vaginal dilators, and instruction in appropriate exercise techniques. A physician's referral is necessary for physical therapy treatment.
Many patients suffering from vulvodynia and/or chronic pelvic pain in particular, have unfortunately suffered with their condition for a great deal of time (years, months) before they reach physical therapy treatment. For women with vulvodynia and/or pelvic pain, the goal of physical therapy is to reduce pain and burning sensations. With further education of patients and physicians, treatment of these conditions through physical therapy will hopefully start to become more mainstream.
The following links will give you more detailed information on this condition.
http://www.nva.org
http://.vulvodynia.com
http://www.med.umich.edu/fp/grants/reed/vulvodynia/references.html
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