Vulvar Disorders: Diagnosis and Treatment

Inspection of the vulva is an essential part of a complete pelvic examination, and yet the area is often overlooked or given only a very cursory examination by clinicians.

For their part, patients can be confused by terminology and are often not aware of the difference between the vagina and the vulva when they are trying to report the location of a symptom or abnormality.

Local treatments may include vaginal estrogen or vaginal estrogens in combination with other treatments. Specialized steroid creams or ointments are often used to reduce inflammation. Use of oral and/or topical medications offer relief for many patients and many times a combination of medications are tailored to meet the patient’s individual needs. Occasionally, surgery is recommended to remove or repair damaged tissue or scar tissue.

You already know ... vulvar and vaginal discomfort causes emotional distress, anxiety, and can be difficult to cope with. Vulvar discomfort can lead to difficulty with daily activities and negatively impact intimacy and relationships.

You may not know ... a vulvar disorder is a “catch-all” diagnosis that can include many different vulvar conditions. These problems, which affect the external genitalia or vulva, can range from mild to near debilitating.

You need to know ... our physician and staff treat these conditions that include vulvar and vaginal pain, vulva, skin conditions, vulvitis including lichen sclerosus and lichen planus, and we treat the problems resulting from these disorders including scarring and painful sex. Disorders of the vulva can be difficult to diagnose and manage. We are dedicated to determining an accurate diagnosis and providing an effective treatment plan.

Vulvar diseases

Infections include vaginal infections such as yeast that may extend to the vulva. Other infectious diseases may include Trichomonas or other sexually transmitted diseases.
Skin conditions include a variety of disorders that impact the vulva including lichen sclerosus, lichen planus, contact dermatitis, chronic dermatitis, and atrophy. Some of these diseases require management on a long-term basis and treatment is necessary to avoid conditions that may be difficult to reverse.

Dyspareunia or painful intercourse may occur for a variety of reasons. The pain may be located at the opening or introitus, deep inside, or both. Causes are usually multiple and may include things other than vulvar disorders including atrophy, muscle spasms, or prior vaginal surgery.