Dysaesthetic Vulvodynia

Dysaesthetic Vulvodynia (previously called essential vulvodynia) has much in common with vestibulitis but the pain and burning, instead of provoked by touch or pressure, is constant. The pain sensation is often described as a nerve-type or neuralgic pain. Although the skin looks normal, the nerve fibres in the vulval skin may be damaged or irritated and on 'high alert', causing pain, burning and aching regardless of touch or pressure. The pain can affect more than just the vulva, such as the inside of the thighs and the anal area, and some women experience pain when emptying their bowels.

The term vulvodynia can be very confusing. It was used, and sometimes still is, as a general term for vulval pain including those types with known causes such as infection and skin problems. In 1991, the International Society for the Study of Vulval Diseases redefined the term to describe women with unexplained chronic vulval discomfort characterised by burning, stinging, irritation and rawness, i.e. vulval vestibulitis and dysaesthetic vulvodynia. Additional confusion arises when the terms vulvodynia and dysaesthetic vulvodynia are used interchangeably.

Like vestibulitis, dysaesthetic vulvodynia (DV) is diagnosed after all other causes of similar symptoms are ruled out. Treatment can include the same anaesthetic jellies and soothing emollients as for vestibulitis. As the pain seems to involve the nerve fibres, treatment with drugs that affect the nervous system can be helpful. The anti-depressant Amitriptyline is often prescribed for this reason and treatment can last up to six months. Side effects, such as a dry mouth and tiredness, are common and constipation may occur as well.

Self-help remedies to soothe the painful areas as described for vestibulitis (ice bags, Aveeno sitz baths etc.) can also be used for DV.