Vulvodynia | Vulvar pain

Etiology
  • Secondary
    • Infections: candida, herpes
    • Dermatoses: erosive lichen planus, lichen sclerosus, atopic dermatitis, psoriasis
    • Hormone deprivation atrophy
    • Alcock’s canal syndrome
    • Vaginismus
        • notion image
  • Primary - Essential vulvodynia
    • Pathogenesis
      • Alteration in pelvic muscle function
      • Alterations in the sensory system
    • Diagnosis
      • Rule out secondary causes
      • Normal microbiological tests at least 2 separate occasions
    • Treatment
      • Antidepressants and antiepileptics
        • Tricyclic antidepressants (amitriptyline, nortriptyline)
        • Gabapentin, pregabalin
        • Duloxetine (up to 120mg/day)
        • Venlafaxine (up to 150mg/day)
      • Physiotherapy
      • Surgery
      • Nerve blocks
      • Intralesional injections: botulinum toxin, triamcinolone