Multiple therapeutic approaches: don't give up on Tx for persistent vulvodynia.(Gynecology)

LAKE BUENA VISTA, FLA. -- Vulvodynia is not the rarity it has traditionally been considered, and the continuing uncertainty about what causes it is not an obstacle to effective treatment, Dr. Barbara D. Reed said at a meeting of the American Society for Colposcopy and Cervical Pathology.

"We used to think about 150,000-200,000 women in this country had vulvodynia. That number was tossed around for a long time," she said.

"But we did a survey, sending out 3,000 e-mail invitations to women asking them about vulvar pain, and 1,024 responded," she said. Participants ranged in age from 18 to 78 years.

Half reported that they had had vestibular pain with intercourse at some point in their lives, 28% had vestibular pain, and 3% reported that the vestibular pain had persisted for more than 3 months.

Based on the survey results, Dr. Reed now estimates the prevalence of vulvodynia to be 1.7% of the female population. This translates to 15 women in each family physician's practice, and at least double that in each gynecology practice--totaling about 2,400,000 women in the United States, said Dr. Reed, professor of family medicine at the University of Michigan. Ann Arbor.

The condition is characterized by burning, irritating pain and itching and typically is exacerbated with intercourse or tampon use. There is no evidence of an infectious or dermatologic etiology.

Nor is it a psychiatric condition. "Women with vulvodynia are psychologically very similar to controls," she said. They also are not sexually averse, and do not have higher reported rates of childhood sexual or physical abuse, she added.