Painful sexual intercourse? It could be Vulvodynia

It is estimated that the most relevant cause of pain during sexual intercourse among women under 30 is precisely vulvodynia. An often silent pain: from a telephone search in the USA it emerged that over half of the women who reported disorders attributable to vulvodynia had never referred to the doctor. At the same time, the search for listening and help can lead women to turn to different figures, from the general practitioner to the specialist up to "alternative" therapies, without necessarily finding the answer to the problem and reaching a diagnosis.

Often in fact, between gynecologist and urologist it is precisely the joint work of both that can help to identify diagnosis and subsequent therapy, as explained by Dr. Daniele Porru, Urologist Specialist in the Complex Structure of Urology at the IRCCS Polyclinic S. Matteo Foundation in Pavia and urologist consultant at the IRCCS Mondino Neurological Institute Foundation of Pavia. "Vulvodynia involves a part of the body that performs in addition to the sexual function also that of eliminating urine, because the urethra is located in the vaginal vestibule, and it sometimes happens that the gynecologist needs the urologist to be able to identify and treat pain in the 'urethra, or who suspect a bladder origin of pelvic-perineal pain ”.

Not being able to find the right interlocutor immediately entails both a cost on health care costs, but above all a growing discomfort that forces women to be absent from work for long periods, to neglect interests and family relationships, as well as avoiding sex for fear of trying ache.

According to the VulvodiniaPuntoInfo ONLUS Association (which established November 11 as International Vulvodynia Day by launching the hashtag #VULVODYNIADAY), despite the high incidence - 1 woman out of 7 in the world suffers from it - 4 million in Italy alone, vulvodynia it is an underdiagnostic pathology, because it is unknown to many doctors.

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The alarm bells are pain and burning, sometimes even spontaneously felt, without having had sexual intercourse, explains Dr. Porru. "In fact, it may happen to experience abnormal sensations, such as hypersensitivity in the perineum-vulvar area, such as pinpricks - as often reported by patients - at other times burning, more rarely a sensation of pulsation, at other times a sensation of itching.

“All these are signs of a possible neuropathic alteration of the peripheral perception of the nerve branches of this area,” says Dr. Porru. "Ultimately, these are signals that involve the nerves of the external genitalia, but come upstream from the pudendal nerve that provides the innervation of this entire area.
Since this is a painful syndrome, explains Dr. Porru, the causes can be multifactorial. From recurrent urinary infections that creams whose prolonged action over time is essential. Last but not least, muscle rehabilitation, since, as Dr. Porru states, "in vulvodynia the inflammatory pathology of the nervous network is very often associated with pain and hypertonicity / contracture of the pelvic muscles, and the latter in turn creates the conditions for the persistence of pain, closing the vicious circle that self-maintains it.

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