How to Heal and Treat Vulvodynia

How to Heal and Treat Vulvodynia

Vulvodynia affects over 14 million people in the US alone. This complex pain syndrome is a frustrating condition to treat. Vulvodynia is a condition that causes pain in the vulva (or specifically in the vulvar vestibule). The root cause of vulvodynia is not fully understood.

Vulvodynia is most bothersome when provoked and when the tissue is irritated. This often happens during sex, when wiping after using the bathroom, when wearing tight pants, sitting, etc. If it’s generalized, the pain can surface at any time.

Like any other chronic pain condition, vulvodynia has body, mind, and spirit components. My clients usually find it easier to start with creating optimal conditions in their bodies. Physical changes are often easier to make than emotional or spiritual changes.

black woman with her hands on her pelvic in pain

The 6 steps that we work through to resolve vulvodynia from the root cause with each of our unique clients.

Structural

There are muscles just inside of the vulva that supports the vagina, bladder, and rectum. These muscles are an integral part of the pelvic structure. Just like any other muscles, these can be tight, weak, and/ or in spasm.

Working with a highly skilled pelvic floor physical therapist can help to find specific muscular or soft tissue issues.

Next, it’s time to develop a specific program of exercise, muscular relaxation techniques, manual therapy, or self-massage. This program sometimes includes or is combined with energy work, visualizations, affirmations, or breathwork that can relax, stabilize, and strengthen the tissues.

black woman doing yoga

Nervous System Quieting

Many people with chronic pain live in a state of “fight or flight.”

If the nervous system is in overdrive is important to practice strategies that help to calm the nervous system. IT is crucial to help the body to become less sensitive to irritating stimulation. Irritating stimulation can contribute to and worsen chronic pain.

Our nervous systems can become sensitized for many reasons, such as:

  • Lack of sleep
  • Excessive intake of inflammatory foods
  • Emotional stressors
  • Chronic infections
  • Excessive environmental toxin exposure
  • Pain “cross-talk” from the reproductive organs, bladder, colon, etc.

Each person needs a unique nervous system quieting program that is tailored to her needs. For most of my clients, sleep strategies are essential.

As well as mindfulness, yoga, breathing exercises, and minimizing inflammatory foods can be helpful.

Individualized testing for yeast infections, bacterial vaginosis, or other more rare microbes can be essential if we suspect underlying chronic infections.

There are also tests available for environmental toxin stress, that can sometimes be helpful.

best probiotics for pelvic pain. visual model of intestine with three spoons filled with probiotics

Digestion

In every case, finding each client’s optimal, individualized food plan is essential. A personalized elimination diet guided by a professional nutritionist can help determine the foods a body is uniquely sensitive to.

If you’re looking for in-depth about how to safely conduct an elimination diet for chronic pelvic pain, you can read more about Outsmart Endometriosis Health Coaching program here.

Unfortunately, there is no “Vulvodynia Diet”.

Not only are each person’s food sensitivities unique, but their digestive function challenges are also unique.

For example, a person can eat the best diet in the world and still struggle to absorb nutrients. They could struggle with nutrient absorption if they have issues with low stomach acid, sluggish digestive enzymes, inflamed bowels, or constipation.

This lack of nutrient absorption is blocking the healing of the irritated digestive system, which may be irritating the vulva. The vulva is close to the rectum it is common that if one is irritated the other will also become irritated. This is called organ cross-talk.

Individualized stool testing and empiric testing can help us to determine each person’s most beneficial combination of foods and supplements.

This list of beneficial foods and supplements is designed to reduce chronic inflammation and support optimal nutrient absorption. This is crucial for giving the body all of the vitamins, minerals, proteins, and fats that it needs to heal.

Are you a nutritionist, health coach, physical therapist, gynecologist, naturopath, or another medical professional who works with women with chronic pelvic pain? Learn more about our integrative approach to Chronic Pelvic Pain and become a Certified Women’s Health Coach. Click here to learn more.

fresh vegetable assortment on table

Nutrient Deficiencies

Many people with vulvodynia lack essential nutrients for the vulvar, vaginal, and pelvic tissues to function optimally.

In my vulvodynia clients, it is common to see deficiencies of vitamin D, omega-3 fatty acids, antioxidants, B vitamins, and magnesium. Specifically on their nutrient deficiency and organic acids tests.

It is important to address each person’s unique nutrient deficiencies with targeted supplementation. This is important to maintain optimal vulvovaginal and general health long term.

Some nutrients with the best evidence base to generally reduce chronic pain include:

Omega-3 Fatty Acids – 3000mg total daily (in 2-3 doses), You can get high-quality omega-3 fatty acids and Vitamin D3, here, with 2-3 capsules per day.

Vitamin D3 (best if taken with Vitamin K2) – 2000IU – 5000IU daily. Anti-inflammatory polyphenols… I like this combination of 2 capsules daily.

Endocrine System

Optimal hormone balance is essential for lubrication of the vulvovaginal tissues and the strength of the pelvic floor muscles.

Plus, having optimal stress hormone balance helps to keep the nervous system calm. Many women with vulvodynia have low estrogen, progesterone, and/or testosterone.

Many struggle with high cortisol and/or low melatonin.

Some women with vulvar pain also have thyroid issues and/or chronic fatigue that may be hormonally related.

It is important to test to see how hormone levels are imbalanced.

Testing can help us to figure out which hormones are imbalanced, why, and how to balance them from the root.

It is crucial to understand why estrogen is low and how estrogen breaks down in the body. Solely applying topical estrogen cream on the vulva will not be an effective long-term treatment. You have to address the root cause of the pain for long-lasting relief.

Narrative Medicine

After you’ve worked to address structural, nervous system, digestive, nutrition, and hormonal issues. It’s time to tune into what the pain is trying to say.

In fact, we usually address all six of these factors concurrently with each of our clients.

Many people with vulvodynia have experienced trauma or abuse. Addressing past trauma with the help of a skilled psychotherapist in pelvic pain is key to healing recurrent vulvodynia pain.

In addition, our integrative approach helps clients to work through practical stressors, whether they have had trauma or not, that can be contributing to the pain.

Stressors can include anything from work, relationships, parenting, or a lack of feeling safe in their body or life.

Our clients often feel a lack of safety in their bodies. They feel a lack of financial safety. They have deeply ingrained societal messages of sexuality being shameful. And, many of our clients are overgiving to the point of exhaustion.

Addressing common emotional, spiritual, and practical challenges that so many people face is our specialty.

In narrative medicine, a person’s stories, beliefs, support network, and goals are all a part of the root cause healing process.

Our clients work to learn what their unique bodies, mind, and spirit need to help. They learn how to tap into their body’s own healing ability. The person’s mind, body, and spirit do the healing. We just support them to create the environment in her body and life to make healing easier, quicker, and more complete.

Read on to learn more about the specifics of one of our client’s unique pelvic pain recovery journeys.

We recently published her case in the peer-reviewed journal, Integrative Medicine, A Clinician’s Journal.

Are you a nutritionist, health coach, physical therapist, gynecologist, naturopath, or another medical professional who works with women with chronic pelvic pain? Learn more about our integrative approach to Chronic Pelvic Pain and become a Certified Women’s Health Coach. Click here to learn more.

 

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14 thoughts on “How to Heal and Treat Vulvodynia

  1. Hi there. i am currenty seeing a phsyio that is helping me with the above. She is happy with my progress so far and it seems the inflammation is gone now (from taking amitryptaline) and alot has improved since she started the manual work. I am now not really in pain but due to the hypertonic muscles as a result when i walk i feel sharp nerves throughout my genital area? that has lessened somewhat but isz still there. i have only had 5 pt sessions. i just wanted to know why the internet seems to have a grim outlook about the diagnosis when your page and my pt say it can be healed? What are your thoughts. I became very fearful and sunk into an anxioud and depressive state from reading google and other peoples stories where they never found a way out. Would love toy hear from you your page is fantastic.

    • Hi! Thanks for your reply. It’s great that you’re in the good hands of a pelvic specialist physical therapist. It can take some time, but even addressing nerve pain is definitely possible with more time in PT, and by making some nutrition and other lifestyle shifts. Continue to work with your healing team. I have seen thousands of women heal from vulvodynia symptoms over the years. There is much hope for you!

  2. Hi,
    I have had vulvodynia for 14 years, I’m 41. I have up on healing myself because I couldn’t find the answer. Pain has worn me down and my nervous system has taken a battering. I just read your info and feel re-inspired to try again. I have definite hormone issues and stomach issues!
    I really need some hope.
    Thankyou

  3. Stephanie Copeland says:

    Hi, so I was diagnosed with vulvodynia last week and I’m so frustrated with the lack of information my doctors have to help me with. I’m not even sure where to turn to test my digestion for food sensitivities. I’ve been tested for food allergies, but that’s not the same thing as being intolerant so now I’m at a loss.
    Also, I would love to test to see if I have any nutrition deficiencies but I’m not sure where to go to get that done either. My regular doctors office? Thanks so much for any help you can give me.

  4. Mary Kennard says:

    Wow I wish I had a clinic like this near me! I’ve had vulvodynia for 13 years now. I suspect it was from a low dosage birth control pill I was on when I was 18 because 2 months later I randomly got vulvodynia. I’ve read that it can upregulate testosterone binding proteins and make it so that less free testosterone is available. I’ve tried to get my hormones tested butmy doctor said he can’t order that test unless I’m trying to get pregnant and can’t for 6 months or if my periods are irregular. Very frustrating. I’ve also suffered from acid reflux almost my whole life and have just recently realized that melatonin deficiency is linked to acid reflux and now possibly vulvodynia?! I don’t eat inflammatory foods except alcohol on weekends but before a couple years ago I never drank and still had vulvodynia and acid reflux. I’ve cut out dairy for a very long time as I know it makes me feel awful and no more birth control hormones for the last 7 years. Makes me very hopeful for finding a solution when I read all these possible causes like this! Do you have any clue how I can get my hormones tested in Canada? Or know of any clinic in bc that I could go to for this?!

  5. Where is this treatment located? I have vulvar vestibilitis. I think this would benefit me greatly. I was seeing a specialist that gave me dilators and estrogen cream. Another dr said to get surgery. I have tried the cream and dilators but I want something more holistic. Pieces seem missing and I don’t have lasting relief. I was told I have vaginitis that is the result of not having enough glycogen in my Vagina and was given estrogen and metro gel… just seems like chemicals and I’d love to work in this as a mind body approach. Any help would be appreciated or advice of where to go.

    • Hi Sara, I do see clients through my practice in Fairfield, CT. However, I can work with clients via telehealth anywhere in the world. The best thing to do to see if I can help you is to schedule a consult with my office. Please call Gloria, our office manager, at 203-254-9957 to schedule a consult.

  6. hello, i have suffered from vulvodynia for ten years or so now. i am wondering if anyone has any recommendations for clinics/specialists in England as everywhere i look there is much positive news from other countries but never England 🙁 all my specialists seems to want to do is pump me full of pills! Thankyou in advance , a very disheartened Mel.

  7. Thank you for this very helpful article. I was recently diagnosed with vulvodynia and am looking for natural options for management and treatment. I wondered if you had any suggestions for a recommended dosage for magnesium supplements. Thank you.

  8. How I manage my vulodynia naturally.

    It started in 2017, after lots of sex over a weekend and my lower back went numb. Then a pain down my left leg from the hip. I read it may be cause by nerve damage, like sciatica, but in the nerve that runs beside it.

    It started with vaginal opening going red raw and then moved onto the lips. Burning red raw skin, then at times incredibly itchy. Seemed to go in a 6 week cycle, till a near normal vulva again. Then something would kick it off again.

    For me it was like the vulva was constantly shedding layers of skin. After red raw, finally reaching soft new skin. Then it would start over again. I also had occasional stabbing pains in various places on the vulva.

    As doctors seemed to know very little about it, I took some tips from blogs. And tried to monitor what I was doing to cause it.

    1 – So I started stretching my legs and back, got more into regular stretching, yoga and exercise in the pool. Concentration on my left leg. My back is so much better. Still think the back/nerve damage was the cause of vulvodynia to start with.

    2 – Kept it clean, washed after urinating, more showers.

    3 – I have not worn underwear in the last 40 years, so its easy not to. I usually wear loose dresses, so tight pants etc I only wore occasionally and it usually irrigated it.

    4 – Applied emu oil (excellent skin protector and healer/rejuvenator). Paw Paw ointment, good barrier cream if cant wash yourself after peeing. Coconut oil also soothed it. Always felt better when moist/oiled. Dry was not comfortable.

    5 – I read about Emuaid (USA made) and got some and was the first relief I had had in 6 months, worked a miracle. Then found Aussie made, Dr Nerida’s Skin Aid, its great too.

    I had sex, at various stages of cycle, and usually the pleasure relieved the pain, and a few good orgasms eased all symptoms for a few days, then it would return. Coconut oil is great as lube. And anything with emu oil in it soothed and healed the sex wear and tear.

    After 4 years, (so much agony, so little sex) I still could not work out what made it flare up. Except when I’d hurt my back and felt nerve pain down the left leg. I always maintained the 5 points above regime to keep it under control.

    I finally got so sick of it I’d thought I’d try acupuncture. Chinese medicine is great at diagnosing the root cause of an illness/condition. She found my body was too hot.
    So I was to stop eating chilli and hot spices etc. (I did love mild chilli on just about everything and used Indian spices in everything). Also, the long list of foods that heat the body I cut out.

    A quick change it diet relieved it immediately. I have kept up the cool foods diet to keep my body cool on the inside (I live in the tropics so hard not to be hot on the outside). Now I only have flare ups when I eat chilli. I maintain the 5 points above, because its still there slightly all the time. But so so much better.

    The acupuncturist only stuck a few needles in me. She said massage these points regularly and up my lower left leg. I do and keep it up. I have not been back, as her advice worked for me.

    After 4 years of an excruciating vulva, the care and maintainece of myself as above, (so I should at age 60) now has vulvodynia is maintained to near nothing, with a healthy sex life. Looks like I have to live with it, lets hope one day it just disappears.

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