Hi.  I’m V.  Unsexy is a memoir-style blog about my experience with Vulvodynia.  It’s meant to educate and provide moral support to any woman experiencing this condition, and maybe create a sense of community through anonymous commenting.  I am not an expert — unless you define someone who has been feeling pain in her vulva since she was 18 an expert.  This is simply my story, and I commit to providing references for any claim I make.

What is Vulvodynia?
Vulvodynia (also referred to as Pelvic Pain) is defined by the National Vulvodynia Association as “chronic vulvar pain without an identifiable cause.”  This pain may be intermittent, constant, triggered, and feel like a cutting or burning of the entire vulva (including the clitoris, labia, and vaginal opening) or just a part.  It has no known cure, and may present in combination with other chronic pelvic conditions (like Lichen Sclerosis, IBS, or Interstitial Cystitis).

In some cases, this chronic pain disorder can turn into a negative feedback loop, with muscles tightening to protect a sensitive abdomen / vulva, which pulls on already sensitive nerves, which causes muscles to further tighten…

What kinds of Vulvodynia are there?
Unfortunately, many websites say there are only two types of Vulvodynia — Generalized (all over) and Localized (just the vestibule).  I know from personal experience that this is incorrect.  Here are the variations that I have confirmed.

How is Vulvodynia treated?
Well, it depends on your doctor, and some don’t know what it is.  Misdiagnosis is common.

The most common treatments are physical therapy (internal and external), antidepressants and anti-seizure medications, local anesthetics, and hormones.  The last is debated greatly, with some researchers now suggesting that early use of Oral Contraceptive could contribute to this disease later in life (unconfirmed as yet).  In extreme cases, surgery may remove the sensitive tissue and nerves.

Personally, I have tried Gabapentin, Nortriptyline, and Wellbutrine orally, physical therapy which I felt invasive, dilators (not for size but to get my body used to being ok with that kind of interaction), yoga, Lidocaine cream topically on the vulva, and a compounded topical cream of Lidocaine, Gabapentin, and Ketamine.  I’ll write a separate post about my treatment experiences.