Vulvodynia
| Classification according to ICD-10 | |
|---|---|
| F45.34 | Somatoform autonomic dysfunction of the genitourinary system |
| ICD-10 online (WHO version 2019) | |
Vulvodynia - also known as vulvodynia in Latin - is the name given to abnormal sensations and pain in the area of the external, primary sexual organs of a woman , for which often no recognizable causes can be found.
Clinical appearance
The complaints range from feeling sore to burning to pain. Touching in particular can be experienced as uncomfortable, making it impossible for women to wear underwear, for example.
causes
Often no cause is found. In some cases, however, skin diseases such as fungal infections, genital warts ( condylomata ) or irritation of the skin, for example from soaps, care products or intimate care products, are blamed for this. Depression is also a possible cause. Hypersensitivity to certain food ingredients, certain histamine liberators, can lead to the release of histamines from mast cells , which cause sharp pain, a few to thirty minutes after eating foods containing oxalate or glutamate, for example . A two-week diet of just a few low-irritation foods can then lead to education.
diagnosis
The diagnosis of vulvodynia is usually a so-called exclusion diagnosis. Tests are carried out for an infection. This includes fungi, bacteria and possibly also on genital warts ( condylomas ).
If the findings are normal, a tissue sample can be taken under a colposcopic view, in order to e.g. B. to exclude an autoimmune disease of the tissue. In rare cases z. B. atopic dermatitis of the vulva.
Based on the exact description of the pain (dull, stabbing, radiating or not, localized or wandering, constant, pulsating, time-dependent, cycle-dependent or independent, (independent /) dependent on physical stress, without external signs or with reddening / swelling / ..., immediately psychologically stressful or ignorable) it may be possible to narrow down what kind of cause of pain it may be.
therapy
Treatment depends on the cause of the vulvodynia.
If there is a fungal infection behind it, it is treated accordingly with antimycotics . In the case of recurring infections, possibly also as a tablet treatment, so that the frequently used creams do not lead to a worsening of the discomfort of the skin due to their ingredients.
If bacterial infections are the cause, these are specifically treated with an antibiotic after the bacterium has been identified and a sensitivity test. Should a nerve irritation (e.g. pudendus) be the cause, this should be treated accordingly.
If no specific cause can be found, therapy with tricyclic antidepressants can be used. Treatment with anticonvulsants (e.g. pregabalin ) is also possible. These remedies reduce the sensitivity to pain / itching. Muscle tension or pain can be relieved through pelvic floor training, in individual cases through the additional administration of muscle relaxants (drugs that reduce muscle tension).
Individual evidence
- ↑ Paul L. Janssen, Peter Joraschky , Wolfgang Tress (eds.): Guide to Psychosomatic Medicine and Psychotherapy: Oriented on the advanced training guidelines of the German Medical Association . 2009, ISBN 978-3-7691-0551-3 , pp. 269 ( google.de [accessed on September 2, 2015]).
- ↑ R. Paus u. a .: Dermatology checklist: venereology, allergology, phlebology, andrology. Georg Thieme Verlag, 2010, ISBN 978-3-13-152626-7 , p. 559, books.google.de
