Vulvodynia in Indian Women: A Study of the Magnitude of the Problem and its Management Outcome

Objective: To determine the magnitude of the problem of vulvodynia and evaluate its management outcome in women presenting with its localized provoked subtype Materials & Methods: One hundred women with vulvar pain or dyspareunia of minimum six months duration were evaluated. Women with a definite causal factor for their symptoms were treated as per standard of care. Any discharge present was evaluated based on clinical characteristics, microscopy and fungal culture, and treated appropriately. Women with clinical diagnosis of vulvodynia were selected for further evaluation. These women were evaluated for response to local 4% aqueous lignocaine and responders were treated with long-term lignocaine. Topical betamethasone was advised to those unresponsive to lignocaine therapy. Results: Provoked vulvodynia was present in 31/100 women. lntroital dyspareunia was the most common symptom (n=29, 93.5%) and the majority (n=27, 87.1%) presented with a combination of symptoms. The posterior vestibular region was the most commonly (>90%) involved site, with 27 (87.1%) having tenderness of grade 1-2. Twenty nine women were positive for 4% lignocaine test and received lignocaine with or without antimicrobials. Of these 20(68.5%) responded. Amongst the rest, six responded to topical betamethasone. Three women were advised surgery but did not agree. Conclusion: Vulvodynia is an under-reported condition. Awareness and stepwise treatment can provide relief to the majority of women. Keywords: Vulvodynia; Provoked; Localized; Dyspareunia