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Vaginal pain severe enough to stop a woman from having sex, or even inserting a tampon, is more common than doctors have been aware, according to a recent survey of more than 1,000 women published in the Journal of Lower Genital Tract Disease. As many as 30 percent of women surveyed said they had experienced such pain, and 3 percent reported having chronic pain lasting at least three months.
This serious yet underreported condition, known as vulvodynia, may be caused by hypersensitive nerves at the opening of the vagina. It's characterized by irritation, burning, and itching to the point where it can affect a woman's daily life and even threaten her marriage. Doctors aren't sure what triggers the hypersensitivity, but they suspect injury to the nerves (caused by a physical blow or an infection) or spasms of the muscles that support the pelvic organs, which can send misguided signals to the nervous system.
"Many women put up with the pain not knowing that they have an actual ailment," says Barbara Reed, MD, a professor of family medicine at the University of Michigan, in Ann Arbor. "Or they think they have a yeast infection that can be treated with over-the-counter medications."
Even when women do go to their doctor for the condition, it is often incorrectly diagnosed because some physicians may not be familiar with vulvodynia, says Gae Rodke, MD, a senior attending physician at St. Luke's-Roosevelt Hospital Center, in New York City, and coauthor of The Vulvodynia Survival Guide (New Harbinger, 2002). The nerve disorder is difficult to diagnose because the symptoms mimic other common conditions such as yeast or bacterial infections.
The first line of defense is prescription medication to control nerve sensitivity and blunt the burning sensation. Another option is biofeedback therapy. In severe cases, surgery to remove sensitive tissue may be necessary.
If you suspect you have vulvodynia, talk to your doctor. "Using the term 'vulvodynia' will clue in the physician to learn more about how to treat it or refer you to someone who can," says Dr. Reed. Or try the nonprofit National Vulvodynia Association at www.nva.org.
Originally published in Ladies' Home Journal magazine, August 2004.