Treatments for vulvodynia focus on relieving symptoms. No one treatment works for every woman, and you may find a combination of treatments works best for you. Available options may include:
Currently there is no specific cure for vulvodynia. Instead, treatments are provided to aid in symptom relief. These treatments include drug therapies such as tricyclic antidepressants or anticonvulsants, nerve blocks, interferon, biofeedback, diet modification, and topical corticosteroids. The antidepressants are for women who become depressed because the vulvodynia has interfered with their quality and way of life. Interferon is a protein designed to protect against viral infection. Biofeedback is a training program designed to develop the individual's ability to control the involuntary nervous system. Using this technique, the woman may be able to relax the muscles in the pelvic organs that may be having spasms and causing pain.
Surgery is an option for some women only when other treatments do not produce satisfactory relief. There are two types of surgery available: scalpel and laser. Scalpel surgery involves excising the sensitive areas around the vaginal vestibule and then pulling the healthy skin over the excised area. Recovery time for this procedure can take weeks. Laser surgery involves the same procedure but instead of a scalpel, a laser is used. Recovery time for laser surgery can take longer and be more painful than with scalpel surgery.
Another type of laser surgery involves using a flashlamp-excited dye laser to solidify symptomatic blood vessels below the skin or to remove chronically painful Bartholin's glands (located on each side of the vaginal opening). In one study, this surgery had a success rate of 92.5% in patients complaining of pain only on the surface of the vaginal area; those complaining of pain on the surface plus deeper pain had an 80.3% success rate. Pudendal nerve decompression is a surgery in which the pudendal nerve is cut. The basis of this surgery is that the pudendal nerve may be a source for the pain involved in vulvodynia. This surgery is performed through an incision near the anus. In one particular study, this surgery provided relief in 9 out of 11 women.
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