Gynaecology

Vulvovaginal Disorder

Vulvovaginal Disorder

Vulvovaginal disorders describe the range of diseases and conditions that affect the vulva and vagina. Some of the vulvovaginal disorders are:

  • Recurrent or Chronic Thrush
  • Vulval Pain (vulvodynia)
  • Pain During Intercourse (vaginismus)
  • Vulval skin problem and irritations (such as allergic reactions and Lichen Sclerosus)

Here is a brief description of some of these common disorders and their symptoms, as well as your next steps if you believe you are suffering from one of these disorders.

Recurrent or Chronic Thrush

Thrush is an itchy infection that affects the vulva or the vagina and is experienced by 75% of women at some point in their lives (according to the Australian New Zealand Vulvovaginal Society). It is caused by yeast (Candida) and is also called candidiasis.

Some women suffer from frequent or recurrent attacks of thrush, despite successful antifungal treatment at the time. It is thought that this group of women may be reacting to the presence of the fungus with a severe form of dermatitis.

Common symptoms include:

  • Itchiness
  • Pain during sexual intercourse and/or urinating
  • Soreness
  • Discharge
  • Inflammation and redness around the vulva and the vagina

Women suffering from chronic or recurrent thrush typically experience most of these symptoms but usually do not suffer from a large amount of discharge (compared to sufferers of acute candidiasis)

Thrush can affect anyone, however, the cause of recurrent or chronic thrush is still not clear.

The symptoms can be worsened by:

  • Being Diabetic
  • Antibiotics – which tend to promote yeast growth
  • Prior to menstruation
  • Other things that also affect symptoms include overheating, sex, tight clothes and use of strong cortisone creams

Vulvodynia

Vulvodynia refers to vulval pain or discomfort.

Common Symptoms

As the name of this condition suggests, the chief symptom of vulvodynia is vaginal pain or discomfort.

The pain may be constant or intermittent, some women only experience vulval pain during sexual intercourse.

Commons Causes

There are many conditions which may lead to vulval pain including:

  • Skin Diseases like dermatitis, psoriasis or lichen sclerosus
  • Vaginal or Vulval infections, such as thrush or genital herpes.
  • Bladder Infections.
  • Bowel Problems.
  • Back Problems like sciatica
  • Nerve Disease and Damage.
  • Pelvic Floor Muscle Spasm.

Given the range of possible causes of vulval pain, identifying the specific cause is a meticulous process.

Vaginismus

Vaginismus is a condition that affects a woman’s ability to engage in vaginal penetration, and is thought to be a result of an involuntary vaginal muscle spasm.

Painful sex is a common result of vaginismus. Treatments are often a combination of psychological and physical therapies.

Common Symptoms

Common symptoms of vaginismus include:

  • Painful sex – Burning/stinging during sexual intercourse
  • Pain or discomfort inserting tampons
  • Pelvic pain during intercourse
  • Difficult or impossible penetration
  • Ongoing sexual discomfort following childbirth
  • Spasms in other body muscle groups

Vulval Skin Problems

Skin problems of the vulva are caused by a multitude of factors, and in many cases is the result of an allergic reaction to some element in a product or substance. .

Common Causes

Common Causes include:

  • Soap, bubble baths, detergent
  • Adult or baby wipes
  • Lubricants or spermicides
  • Chemically treated clothes
  • Medication (either over the counter or prescribed)
  • Methylated spirits (sometimes used as a remedy for skin problems)
  • Tea tree oil
  • Latex condoms
  • Toilet paper
  • Antiseptics

Lichen Sclerosus

An example of a vulval skin problem is Lichen Sclerosus (LS), while LS can involve any part of the skin it is most common on the genital area.

It can affect women at any age but most commonly seen around menopause.

Common Symptoms:

  • Itchiness
  • Skin splitting open
  • Soreness and painful sex
  • Whitened skin around the vulva, perineum and anus
  • If untreated, Lichen sclerosus may cause scarring which result in the loss of the labia minora (inner lips of the vagina) and reduction in the size of the vaginal opening

There is an increased risk of vulval cancer with Lichen sclerosus therefore a six monthly to yearly check ups is required.

Your Next Step

If you are experiencing any of the symptoms related to these vulvovaginal disorders we recommend making an appointment with Dr Farjo.

Your may need a referral from your doctor or GP (please see Patient Information for more details).

When you visit our clinic for an examination, we will also take a detailed history and may request a number of tests to rule out possible causes such as infection or skin diseases. Dr Farjo may obtain a vulval skin biopsy to confirm or assist in the diagnosis.

Following the examination and once Dr Farjo has the necessary test results she will identify the best treatment options and discuss these with you.

Treatment Options

Treatments will vary depending on your disorder but may include but not be limited to:

  • Advice regarding the vulvovaginal skin care
  • Topical Treatments: Pessaries and creams
  • Tablets such as Fluconazole and itraconazole
  • Botox injections into the pelvic floor muscles in cases of vaginismus or pelvic floor muscles spasm
  • Physical therapy such as physiotherapy
  • Psychological treatments
  • Surgery may be used in some cases