Painful vulva
Any
of the causes of vulval itching may
also cause pain; trichomoniasis, for example, can make the vulva
very sore. But if what you are feeling is rawness and burning
rather than an itchy sensation, you might have herpes. Other
causes include vulvodynia and vulval vestibulitis syndrome.
Genital
herpes
This results from infection with the herpes simplex virus. Small
blisters form on the genital area, and these burst to form small
ulcers, which take about 10 days to heal. If you've not had
herpes before, the first episode can be quite severe.
How it
feels
Your vulva may be very sore, particularly when you pass urine
- it can feel similar to bad cystitis. The lymph glands in your
groin will probably be swollen, and you may have flu-like symptoms
(tiredness, aching muscles, fever) and feel very miserable and
tearful.
You may
feel angry with your partner for giving you this infection,
but it's unlikely that he knew he had it. And don't feel bad
about having it yourself - research has shown that about half
the population has been exposed to the herpes simplex virus,
though it's usually passed on without causing any symptoms.
You were just unlucky to have had the pain and discomfort.
Dr
Margaret's advice
Vulvodynia
This is a very unpleasant burning feeling - the sensation is
unremitting, and is often worse at night. Vulvodynia tends to
be more common in older women. It's only diagnosed when other
causes of pain, such as skin diseases, have been ruled out.
The vulva looks perfectly normal, but the pain is real.
Dr
Margaret's advice
Vulval
vestibulitis syndrome
With this syndrome, the woman experiences severe pain when the
vaginal opening (the 'vestibule') is touched. The syndrome usually
comes on quite suddenly, and it is most common in women in their
20s and 30s. It's very distressing because, as well as having
to cope with the pain, you find that your sex life is zero -
it can even prevent women from using tampons, wearing jeans
or riding a bike.
Dr
Margaret's advice
What
you can do
Read Dr Margaret's advice on:
herpes
vulvodynia
vulval
vestibulitis syndrome
Herpes
Go to your doctor or a genito-urinary medicine clinic to check
that it is herpes. Go promptly, because if it is less than
about 6 days since your symptoms started, the doctor can prescribe
an anti-herpes drug (such as aciclovir, famciclovir or valaciclovir),
and the sooner you start this treatment the better. Then go
home, take a paracetamol for the pain and go to bed. Putting
salt in your bath water can help - if you find passing urine
painful, do it in the bath. After a day or two you will feel
a lot better. Although genital herpes can come back from time
to time, later episodes are never as bad as the first attack.
Vulvodynia
Some women find that the only way to relieve it is to apply
ice, though my 'common-sense steps'
may be helpful, and you may also want to try the non-prescription
treatments recommended by the Vulval Pain Society.
Discuss
it with your doctor, as tricyclic antidepressants often help.
This isn't because you're depressed (or imagining the condition),
but because these drugs suppress transmission in the nerves
of the skin. Your local hospital may have a 'vulval clinic'
that your doctor could refer you to. Vulval clinics are usually
run as part of the hospital's dermatology department, and
the doctors involved will be experts on vulvodynia and other
vulval conditions.
Vulval
vestibulitis syndrome
The condition is not well understood, but many women respond
to steroid creams or other special medication. So your doctor
should be able to help, and might also refer you to a specialist
vulval clinic (as described in 'Vulvodynia'). Meanwhile, follow
the common-sense advice for vulval conditions. You could also
try some of the non-prescription treatments suggested by the
Vulval Pain Society; these can be bought from a pharmacy or
health shop.
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Non-prescription
treatments for vulvodynia or vulval vestibulitis
Homeopathic
treatments for sore and painful skin (try each separately)
aloe vera gel
calendula cream
Dr Bach rescue cream
hypercal cream
Aqueous
cream is a plain, soothing, perfume-free cream.
Many women with vulval pain find this helps as it
soothes and rehydrates the skin. For maximum benefit,
store it in the fridge and use it cold. Unlike steroid
creams, you can use it as often as necessary.
Xylocaine
gel contains a weak amount of the local anaesthetic
lignocaine. It numbs the nerves in the skin and can
be used on a regular basis. It can even be used half
an hour before sex.
Teabags
(Indian tea) contain tannic acid, which is a local
anaesthetic that can calm the burning sensation of
vulval vestibulitis. Put teabags in the bath, or put
a warm teabag on the sore area at night.
Aveemo
(oatmeal) baths are a useful treatment for severe
attacks of pain. You can buy the sachets from health
shops. Put a sachet in the bath and bathe for 20 minutes.
Repeat up to four times a day.
Emulsiderm
bath lotion may also help severe painful episodes.
Thanks
to the Vulval Pain Society (see Useful
contacts) for allowing us to use this information
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