Vulvodynia

Question 1

Vulvodynia definition?

Answer 1

Chronic vulvar pain condition most often described as burning in the absence of clinical findings

Question 2

Localised provoked vestibulodynia? (LPV)

Answer 2

Characterised by tenderness to gentle touch or pressure in the vulvar vestibule

Question 3

Difference between primary and secondary LPV?

Answer 3

LPV that occurs prior to first sexual intercourse or after. Primary is more difficult to treat.

Question 4

Causes of LPV?

Answer 4

Candida, bacterial vaginosis, herpes, eczema, lichen simplex chronicus, contact dermatitis, psoriasis, lichen sclerosis, neoplasia, trauma, vaginismus, puedenal nerve neuralgia

Question 5

Management of LPV?

Answer 5

Trial of candid supression - treatment needs to be prolonged, oral treatments preferred, avoiding skin irritants, topical lignocaine before sex, TCA’s, gabapentanoids, SNRI’s, physical therapy