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Dr. Kala
Dr. Kala, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 4463
Experience:  Caring US educated & trained physician, 26 years of experience in OBGYN & women's health care.
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I have been experiencing vulval pain time. I have had tests

Customer Question

I have been experiencing vulval pain for some time. I have had tests to establish the cause and these were negative. However, sitting down for me is uncomfortable and travelling very difficult. When I sit on a toilet, stand up and after a night's sleep it all but disappears to return as soon as I sit. It is making me feel low some days and I want to try to ease it somehow. I lost 4 stone in weight and it made no difference
Submitted: 9 months ago.
Category: OB GYN
Expert:  Dr. Kala replied 9 months ago.

Hi, I am privileged to help you get more understanding about your current concern. I can also provide you with additional services, such as live telephone or Skype consultation, at a small additional cost. Let me know if you are interested.

A few questions first to clarify your concern:

1. For how long has this been going on?

2. Have you had a biopsy of the vulvar done?

3. When the pain started were you having any accompanying irritation, itching, discharge? if so describe?

4. What medical conditions do you have?

5. Did the onset occur after a new medication was started, i.e 3-6 weeks before onset? if so what is the medication?

Customer: replied 9 months ago.
It has been going on for about 5 years or more. It did not occur after taking medication as I was not on any medication. I have no discharge or irritation really but it sometimes looks a bit dry or red. Swabs were taken by a the specialist. I now suffer from type 2 diabetes( which I reversed with diet) and slightly raised blood pressure. I did have a fall in my kitchen just before the problem occurred where I slipped and my legs went in different directions and I felt I had pulled muscles and pulled my back.
Expert:  Dr. Kala replied 9 months ago.

Thank you for your response.

So as I understand your responses, no biopsy has been taken to date. This would help arrive at a diagnosis & I strongly recommend you ask for one as t might pinpoint the underlying cause. The vulvar area can get irritated from normal activity as we get older because the tissues become fragile as the amount of estrogen decreases. For women after menopause this can be an ongoing problem. Vulvar pain can be due to irritations on the surface of the skin but also underneath. I strongly advise a skin biopsy to make sure there are no underlying abnormalities (aka dysplasia) that can be contributing to your discomfort.

Since the duration is considered to be chronic, it would be helpful for your to take some time to think about what was going on in your life before or around the time of onset. To see if there was anything that could have triggered these symptoms, and then possible help to understand what might relieve them. Triggers can include dietary changes, physical activity changes, change in residence/living, new medicines/cosmetics/other chemicals. While anxiety can cause pain, it is quite possible that the vulvar pain is related to a psycho-social cause. This may be difficult to determine initially and only may truly come to light as you continue to think and ponder about this time 5 years ago.

Finally, if no other cause can be found then the condition of fibromyalgia needs to be entertained. In the evaluation for fibromyalagia a very thorough history needs to be obtained, including the discussion of many of the factors mentioned in the preceding paragraph. A thorough physical examination is also conducted to include nerve and sensation identification. This is often a diagnosis of exclusion and should be treated by a pain management specialist.

Let me know if you have any further questions regarding this question as my goal is to make sure you are completely satisfied with your answer.

Customer: replied 9 months ago.
Thank you doctor. My life at this time was very stressful. My mum had dementia and died later that year, my husband had lost his job, my work was very difficult and unfortunately the stress has not really lessened. I retired 4 years ago and my husband has had many health problems since so my stress levels are constantly high. I will seek further help to manage the condition. I have read descriptions of vulvodynia and they certainly do sound like the kind of discomfort I experience. Sometimes it feels like a paper cut and at others, like I am sitting on boulders. Thanks for your help.
Expert:  Dr. Kala replied 9 months ago.

You are most welcomed.

Please be sure to rate me so I will get compensated for my time and feel free to ask for me for your next health question

Dr. Kala, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 4463
Experience: Caring US educated & trained physician, 26 years of experience in OBGYN & women's health care.
Dr. Kala and other OB GYN Specialists are ready to help you
Customer: replied 9 months ago.
I have rated you and do not need to ask any further questions . Thank you for your help.
Expert:  Dr. Kala replied 9 months ago.

Thanks, ***** ***** wonderful week

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