Pelvic PainVulvodynia generally involves pain, or an unpleasant altered sensation, in the vulva. The actual pain sensations can include any of the following symptoms: itching, burning, stinging or stabbing in the area around the opening of the vagina. Pain in this area can happen for no clear reason and can be constant or occasional and can vary in intensity from an irritating discomfort to intense pain that can be disabling. When this pain occurs because of attempted vaginal penetration with sexual intercourse, it is known as vestibulodynia or vulvar vestibulitis syndrome.
Symptoms may be centred on a particular area of the vulva and may at times have a tender spot or slightly inflamed red area, but more often will have no abnormality evident. The pain may range from mildly irritating to completely disabling. While a distinct sore, or area of redness may be visible, often the vulva and the vagina show no abnormalities or infections on medical examination. This condition can go untreated for years and is often (wrongly) regarded as a psychological problem. An increasing amount of evidence indicates that the difficulties arising from this condition are muscular and respond well to specialised biofeedback training.
Many women find that after childbirth they start to experience the embarrassment of incontinence. But incontinence can also be caused by some pain conditions affecting the lower back, nerve problems affecting the bladder, injury that affects the pelvic region, or various types of infections. This is an area that we are able to help with by means of a combination of state of the art biofeedback as well as some pelvic exercises derived from the well known Kegel exercises.
We have a nurse and a psychologist specialising in this area of pain relief but before accepting any appointments we need to ensure that a thorough medical check has been carried out to ensure that this problem is of a type that responds well to this type of treatment. Essentially any kind of pre-existing yeast condition or pelvic inflammatory disease must be medically treated before attempting a treatment utilising biofeedback. This kind of check is best done at a sexual health clinic or by a gynaecologist and our staff would expect a report from a medical specialist prior to an initial consultation.
This condition can be associated with sexual difficulties that are unrelated to the pain itself. In these situations we may refer the patient to a reputable group such as Sex Therapy New Zealand (http://www.sextherapy.co.nz/) or to one of our other female clinicians for treatment of sexual trauma.
Good web sites for additional information in this area include Dr Glazer (who is regarded internationally as an expert in this field) in the USA:
The Vulvodynia support group in the USA also has some good resources online:
Some good general information is given at the Australian Women’s Health website:
A broader approach is taken by Sex Without Pain who provide some useful answers to common questions:
Some good articles and research based evidence for biofeedback based treatment of these conditions as well as other approaches is given in the Australian site:
In Australia, Marek Jantos has an excellent reputation and has published widely in this field. His website is: