Chronic vulvar pain (known as vulvodynia), described as a burning or stabbing sensation in the area of the vulva, vagina, urethra, and rectum, is a misunderstood and understudied health issue. "It is the condition that everybody thought nobody had," says Christin Veasley, director of research and professional programs at the U.S. National Vulvodynia Association.
Diagnosis is often confusing and difficult for physicians. Millions of North American women, 16 percent according to April’s Journal of the American Women’s Medical Association, suffer from vulvodynia, but nearly 30 percent of these women will not seek treatment for the condition. Patients are often embarrassed to discuss their symptoms with their health professionals so that treatment may be delayed.
The burning or stabbing pain of vulvodynia is either constant or upon contact, ranging from annoying to disabling and lasting three months or more. The pain and tenderness may be so severe, that sexual intercourse and even walking or sitting may be painful. Many sufferers describe their vulvar pain as "a fire that can’t be put out."
Apparent causes of vulvar pain include allergies, food or chemical sensitivities, and/or a yeast overgrowth and irritation or injury of the pudendal nerve, one of the main nerves in the genital region.
Current allopathic (conventional medical) therapies include either surgery or drugs that have distressing side effects. These include:
* Topical anesthetics
* Synthetic estrogen
* Tricyclic antidepressants
* Anticonvulsant drugs
* Interferon treatment
* Surgical removal of troublesome nerve endings
Fortunately, there are natural and safer modalities for treating vulvar pain. All are helpful for reducing or eliminating pain. These include:
* Electromyography with physical therapy
* Electrical stimulation of the pelvic floor
* Dietary, environmental, and lifestyle modifications
Dietary modifications include:
* Following a yeast-free diet if candidiasis is present (refer to October 2003 Conscious Choice article entitled "Beating the Yeast Explosion")
* Avoiding all food-related chemical irritants such as phosphoric acid in soft drinks, caffeine, monosodium glutamate (and its derivatives such as hydrolyzed vegetable protein and autolyzed yeast), aspartame (e.g. Nutrasweet, Equal), nitrates/nitrites, chlorine in water, and food dyes (especially yellow #5 and 6, and red #40)
* Avoiding or moderating intake of foods high in oxalic acid (a strong acid that can irritate tissues) such as spinach, whole wheat, dried beans, and chocolate
* Avoiding all known or suspected foods that trigger allergies
* Avoiding or moderating intake of salicylic acids (especially aspirin, food dyes, preservatives, and high acid foods such as tomatoes, grapefruit, and oranges)
* Adding dietary fiber, especially finely ground flaxseed (one-two tablespoons daily)
Helpful lifestyle and environmental modifications include:
* Eliminating the use of antibiotics, steroids, immune-suppressing drugs, and birth control pills (unless there is an absolute medical necessity)
* Wearing only cotton underwear
* Avoiding pantyhose (wearing thigh high or knee high hose instead)
* Wearing loose-fitting pants or skirts
* Removing wet bathing suits and exercise clothes promptly
* Using dermatologically approved detergents such as Purex or All Free Clear
* Avoiding the use of fabric softener on undergarments
* Avoiding bubble baths, feminine hygiene products, or any perfumed creams or soaps
* Using 100 percent organic cotton menstrual pads instead of tampons
* Avoiding exercises that put direct pressure on the vulvar areas such as cycling and horseback riding
* Enrolling in a mind/body/exercise class such as yoga to learn stretching and relaxation exercises
* Practicing biofeedback
* Avoiding chlorine in drinking and bathing water (also avoid swimming in chlorinated pools)
* Avoiding the use of hot tubs
There are also a number of dietary supplements that have been shown to relieve vulvar pain symptoms and help restore acid balance. They include a basic multi-vitamin/mineral (free of yeast and chemical additives), magnesium, calcium citrate (to remove oxalates), probiotics (to restore healthy intestinal flora), quercetin (a non-citrus bioflavonoid), non-acidic vitamin C, B-complex (free of yeast), and fish oil (high in omega-3 fatty acids).
The good news is that vulvodynia sufferers can "put out the fire" with proactive dietary, environmental, and lifestyle changes. For more information contact the Vulvar Pain Foundation (vulvarpainfoundation.org) or the National Vulvodynia Association (www.NVA.org).
Disclaimer: This column is for information only and no part of its contents should be construed as medical advice, diagnosis, recommendation, or endorsement by Ms. Minsky.
Bonnie Minsky is a Licensed and Certified Nutrition Specialist, Public Health Educator and Certified menopause Educator with a private practice in Northbrook, IL. She can be reached at nutritionalconcepts.com.