Who’s at Risk for Vulvovaginal Disease?

Sexual discomfort can be a source of anxiety in personal relationships. For about 20% of US women that may mean dealing with dyspareunia, or recurrent pain related to sexual activity. 

Many conditions can lead to dyspareunia, including vulvovaginal disease, a group of conditions that affect the external area of your vagina. Vulvovaginal disease can lead to more serious problems if not treated properly. 

Women in the Boston, Massachusetts, area looking for relief from sexual discomfort can get help from Dr. Neeraj Kohli here at BostonUrogyn. We offer advanced technology and customized care to treat an array of urogynecological issues, including vulvovaginal disease.

Types and risk factors of vulvovaginal disease

The characteristic burning, stinging, and other painful sensations associated with vulvovaginal disease may be the result of one of these conditions:

Vulvodynia

Specifically referring to chronic pain and discomfort in the vulva (vaginal opening), vulvodynia can become so painful that sitting for a long time becomes unbearable. It’s idiopathic, meaning the cause largely isn’t understood, and can last months or years, depending on the severity.

Women with injuries, allergies, or sensitive skin in the vulvar region, along with past vaginal infections, or those dealing with hormonal changes are at risk for vulvodynia.

Vulvodynia may lead to sleep disturbances, anxiety, depression, and altered body image. 

Lichen sclerosus

This type of vulvovaginal disease causes thin, white patches of skin to form in your genital and anal area, as well as redness, itching, tearing, bleeding, and in severe cases, ulcerated sores. 

Lichen sclerosus isn’t common but postmenopausal women are at greater risk. A hormone imbalance, previous skin damage, or an overactive immune system also increase your risk.

Complications of lichen sclerosus include constipation, urinary retention, and an increased risk for squamous cell carcinoma.

Vulvar intraepithelial neoplasia (VIN)

VIN is a precancerous skin lesion affecting the vulva that takes two forms, usual and differentiated. 

The usual type is associated with the human papillomavirus (HPV). The differentiated type is often connected to other problems like lichen sclerosus and erosive lichen planus. Chronic inflammatory skin disease is common with differentiated VIN, which starts around age 60.

Treating vulvovaginal disease

A range of treatments are available to treat vulvovaginal disease, including:

  • Creams and ointments

  • Corticosteroids

  • Antidepressants

  • Anticonvulsants

  • Biofeedback therapy

  • Anesthetics

  • Nerve blocks

  • Photodynamic therapy

  • Laser ablation

  • Surgery 

Treating VIN depends on the type and whether cancer is suspected. In some cases when cancer is present, removing the vulva (vulvectomy) may be necessary.

If you’re dealing with severe vaginal discomfort and painful sex, make an appointment with Dr. Kohli and BostonUrogyn today by calling one of our Boston area locations, including Wellesley and South Weymouth, or book your visit online.

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