Vulvodynia refers to chronic pain and discomfort of the vulva, which is the external part of the female genitalia including the labia, the clitoris, the vaginal opening, and the urethral opening. It is characterized by pain lasting more than three months with no known cause or reason. The pain can be generalized over the entire vulvar region or localized to a specific area. Pain limited to the entrance of your vagina is called vestibulodynia. The pain can be constant, or it can occur intermittently such as when the area is touched, during or after intercourse, wiping after urination, or with certain activities such as biking and prolonged sitting. The range of pain can be described anywhere along a continuum from very mild to severe, and it is typically described as a stinging, burning, itching, swelling, or raw sensation.
While the cause of vulvodynia is unknown, researchers believe it may be the result of a combination of factors working together. Some of these include:
irritation and injury to the nerves of the vulva
genetic inclination, allergies, or skin sensitivities
muscle spasm or dysfunctions of the pelvic floor
long term reaction to infections or increased inflammation
Can physical therapy help?
Treatment for vulvodynia typically includes a multi-disciplinary approach. The good news is that often physical therapy can be a key factor in relieving pain and discomfort. Your therapist will perform a thorough evaluation and create a plan of care that is tailored to your individual needs. It may consist of manual therapy aimed at addressing the mobility of your muscles, joints, and connective tissues. You may also work on proper coordination of your pelvic floor to ensure that you are able to contract and relax your muscles at the appropriate times. A physical therapist can also guide you on good genital hygiene practices, activity modifications, and behavioral strategies to help with pain management. Desensitization strategies can also be performed to decrease tissue sensitivity. In addition, your therapist will likely prescribe exercises which may include stretching and relaxation activities, nerve gliding, or strengthening exercises based on what is appropriate for your presentation.
While the diagnosis of vulvodynia may seem overwhelming or scary, working with a physical therapist can help reduce your fears, understand your symptoms, and improve your quality of life.
Looking to connect with a pelvic floor physical therapist?
Ashley Holstein PT, DPT is a native of New Orleans and attended Mount Carmel Academy. She obtained her Bachelor’s of Kinesiology from Louisiana State University and went on to receive her Doctorate of Physical Therapy in 2013 from Louisiana State University Health Sciences Center in New Orleans. Originally starting her physical therapy career in orthopedics, she developed a passion for pelvic health physical therapy when pregnant with her daughter and transitioned to this specialty full-time. Ashley is certified in dry needling and is also an adjunct professor with Delgado’s Physical Therapist Assistant program. Ashley enjoys reading, attending festivals, and spending time with her husband, daughter, and two dogs.
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