First vulvodynia guideline published.(News)

HOUSTON -- A new guideline for the diagnosis and treatment of vulvodynia offers multiple treatment options, including experimental and complementary therapies, for the controversial disorder.

"We have oceans of lotions, potions, and notions out there for vulvodynia. There is not going to be one simple cure," Hope K. Haefner, M.D., the lead author of a paper detailing the guideline, said at a conference on vulvovaginal diseases sponsored by Baylor College of Medicine.

What is clear, she said, is, "We have to do a lot more than say, 'Love burns.'"

Dr. Haefner, director of the University of Michigan Center for Vulvar Diseases in Ann Arbor, recruited a panel of vulvar disease experts to draft the guideline at the request of the American Society for Colposcopy and Cervical Pathology (ASCCP). The guideline is published in the society's journal and can be accessed at www.jlgtd.com (J. Lower Gen. Tract Dis. 2005; 9:40-51).

General gynecologists are increasingly aware of vulvodynia but need to start treatment early, according to Dr. Haefner. "The longer a patient has the pain, the less likely we are going to be able to cure" her, she said.

The guideline uses terminology the International Society for the Study of Vulvovaginal Disease (ISSVD) recently adopted for vulvodynia, which has had multiple names, including vulvar vestibulitis syndrome and vulvar dysesthesia. The ISSVD defined vulvodynia as "vulvar discomfort, most often described as burning pain, occurring in the absence of relevant visible findings or a specific, clinically identifiable neurologic disorder."

Symptoms are not necessarily caused by touch or pressure to the vulva, such as with intercourse or bicycle riding, but these activities often exacerbate the symptoms.