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Q&A: On vulvodynia with Emory Associate Professor of Gynecology, Dr. Kevin Ault 

Learn more about the syndrome that affects 13 million woman a year

One in six women are affected by vulvodynia at some point in their lives. Are you one of them? Find out.

We spoke with Kevin Ault MD, Associate Professor of Gynecology and Obstetrics at Emory University School of Medicine to learn more about the syndrome that affects 13 million woman a year.

What is vulvodynia?

Vulvadynia is chronic pain in the vulva without an obvious underlying cause.

What are the symptoms?

Usually pain with intercourse, although some patients have pain when wearing tight jeans or even when sitting.

How common is vulvodynia -- in your personal medical experiences and (if you know) on a national level?

Approximately 15 percent of women have vulvar pain at some time in their lives.

What causes vulvodynia?

Unknown.

What are some other conditions vulvodynia is often misdiagnosed as?

Usually yeast infection

How does one treat vulvodynia, whether in or outside a medical office?

There are several therapies, but not every therapy works for all patients. I usually say 1) topical medications to decrease inflammation and pain 2) physical therapy 3) pills aimed at chronic pain such as Elavil, Lyrica, Cymbalta or 4) surgery.

My understanding is that some women need to seek physical therapy for their d vulvodynia. How does this work to improve or heal the patient? How common is this form of treatment for vulvodynia?

I think this might be the best treatment. Physical therapy is useful for a number of gynecological problems.

What are some alternative sexual activities recommended for those diagnosed with vulvodynia who cannot have intercourse or the likes?

I am not sure I have thought about this before. Unfortunately, pain with intercourse is associated with decreased sexual desire in general.

How common is it for women who suffer from vulvodynia to have the surgical procedure known as vestibulectomy?

Vestibulectomy is useful for some women, especially if other therapies have not worked.

What exactly is a vestibulectomy?

Removing the painful area of the vulva.

Are there any books on vulvodynia (medical or anecdotal) you would recommend for women (and their partners)?

I would recommend the web site of the National Vulvadynia Association - http://www.nva.org.

Of the women you treat with vulvodynia, how would you characterize their emotional involvement with the diagnosis? As in, are most surprised, familiar with the condition; is there a sense of shame, indifference, surprise, anger, etc?

I think that most people are angry and/or depressed since sex was once enjoyable, and now is painful.

What are some things or acts that women who have vulvodynia should avoid?

No I can't think of any.

I read some women do best in seeking psychotherapy in addition to physical. Why is this?

Therapy once diagnosed. Depression is a common side effect of chronic pain. Also many relationships are also strained by this problem, or even end.

What advice do you have for men who are dating a woman who has been diagnosed with vulvodynia?

Patience. Most therapies work with time.

Contact:

Kevin Ault MD, Associate Professor of Gynecology and Obstetrics
Emory University School of Medicine
The Emory Clinic
Bldg A, 4th Floor
1365 Clifton Rd.
Atlanta, Ga 30322
404-778-3401

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