Vulvodynia causes painful sex and other kinds of pain “down there,” affects millions of women, yet is so often misdiagnosed.
Why is this?
“Dynia means pain, so vulvodynia is pain in the vulvar region – or genital region of the female,” begins Robert J. Echenberg, MD, founder of The Echenberg Institute for Pelvic & Sexual Pain, and co-author of “Secret Suffering: How Women’s Sexual and Pelvic Pain Affects Their Relationships.”
“This anatomical area extends from the clitoris to the sacrum and includes upper aspects of the inner thighs as well,” continues Dr. Echenberg.
“The condition had been labeled ‘burning vulva syndrome’ a number of years ago, and indeed, burning is one of the most common symptoms associated with vulvodynia.
“It is estimated that there may be as many as 15 million women between the ages of puberty and menopause who have these symptoms at various times of their reproductive years.
“Vulvodynia is not a specific entity, but a multifactorial condition. In the local region of the genital area, there is skin, connective tissue, muscles, nerves, blood vessels, lower urinary track and lower bowel and vaginal tissue that make up the vulvar region.”
Why Vulvodynia Is So Often Misdiagnosed
Dr. Echenberg explains, “As a gynecologist for many decades, and even in today’s residency programs and postgraduate education, I did not learn, and there is still very little teaching and education, about these various pain-generating disorders.
“What is taught and practiced is that these symptoms represent the usual infectious problems such as yeast, bacterial and viral infections, even when women complain of persistent itching, burning, numbness, tingling, stabbing, crawling and a myriad of other ugly descriptors of persistent sensitivity in the genital region.
“Vulvodynia may lead to many debilitating functional disorders such as pain with sitting, urination, defecation and especially sexually related pain issues.
“Common vaginitis, urinary tract infections and localized injuries in these locations do not cause such long-term dysfunctions and suffering.
“Consequently, there are large numbers of women going from specialist to specialist and being treated repeatedly with antibiotics, anti-fungal therapies and other localized therapies and not getting significant relief.
“Compounding the lack of proper education about these conditions in medical training programs is the small amount of time given for patient care with complex disorders in our current health care system.
“When women are examined for routine care, very little time, if any, is spent on thoroughly examining and observing the details of the genital region.
“I have seen many obvious inflammatory disorders and subtle lesions and abnormalities in my practice that have been either missed completely or misdiagnosed by numerous previous practitioners.”
Dr. Echenberg combines the most current neuroscience on chronic pain processing, a very personalized bio-psychosocial model approach and 40+ years of medical experience to treat his patients.
