Causes of Vulvodynia
Today’s topic for V Awareness Week is vulvodynia causes. Check out what is vulvodynia if you missed yesterday’s post. I’m writing a series of posts on this chronic pain condition that has affected every aspect of my life for so many years.
No one really knows what the actual cause is, but they do have some theories. I have had the condition for the past five years and I also have some theories as to why I developed it. However, I want to make clear that it’s NOT an STD or an infection. The NVA (National Vulvodynia Association) lists a number of potential causes on their site including:
- Nerve injury or irritation in the nerves that transmit pain and other sensations to the vulva (like the pudendal nerve)
- Increased nerve fiber density in the vulva (they have found that women with this condition have way more nerve endings in that area than the average woman).
- Elevated levels of inflammatory substances in the vulva
- An abnormal response to infection or trauma
- Altered hormone receptors in the vulvar tissue
- Localized hypersensitivity to Candida (yeast) or other vulvovaginal organisms
- Pelvic floor muscle spasm or weakness
- Genetic susceptibility to chronic widespread pain or chronic vestibular inflammation
For me personally, I think mine began as a result of a few different factors. My American gynecologist says I was the perfect storm…I had all the factors and it created this horrible and relentless pain condition.
In December 2005, I developed what I thought was a yeast infection. I went to the doctor who prescribed me the yeast infection cream, Terazol. Mind you, he didn’t take swabs or even do an exam. He just prescribed me the cream. I went home and applied the cream as directed before bed. All was fine. I went to work the next day and by mid morning I started getting burning, shooting pains down the inside of the vaginal wall.
By afternoon, I was on fire. I felt like I had a blowtorch between my legs. It was awful. I thought it was just the yeast infection and it would go away. Well, it didn’t. In fact, the burning increased. I went to the ER and was told by the doctor there that I was probably having an allergic reaction to the yeast cream or the applicator to insert the cream. He prescribed me a steroid cream and Prednisone and sent me on my way. In my gut, I knew it was more. I so wished I had been wrong. I believe an allergic reaction from the yeast infection cream, Terazol, was a trigger for me.
However, there were a few other factors that I want to mention as well that I know now years later. I was on birth control pills as a teenager and into my 20s. The pill can affect your hormone receptors in your vulvar skin. It blocks them so the skin and the nerves change. Dr. Coady said when I saw her for the first time back in April 2009 that my skin was so thin she could see through it. I was in bad need of topical hormones and I was only 31 years old. I haven’t taken the pill since I was 28 and I never will again. They don’t tell you that vulvar pain can be a side effect in the brochures or at least I wasn’t aware of it.
Plus, I had two very hard deliveries and my girls were almost 10 lbs each. I had tearing and so much scar tissue. My muscles really took a beating. I have been in pelvic floor physiotherapy for years and know that my muscles are both weak and very tight. Not a good combo to have.
Every woman will have a different reason why they believe their pain started. These are my theories as to why I am in pain. Believe me, I have thought about what I did to cause this pain or why it’s happening to me. I still don’t really fully understand it and maybe I never will.
Update 2018: I’m pretty sure that tight muscles are a big component of my pain. I’ve been seeing a pelvic floor physiotherapist for over a year. She’s been working on my groin muscles lately and doing some dry needling. Though it hurts afterwards, it’s a good kind of pain – like having a massage. I usually get some relief for a few days after my treatment.
Read the rest of my V Awareness Posts.
What are your theories on vulvodynia causes?