| VULVODYNIA SUPPORT NETWORK WELLINGTON, NEW ZEALAND |
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| Our Mission: To assist New Zealand women in accessing resources and information to help them to find the support theyneed to deal with and overcome vulvar pain. |
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| Common Vulvodynia Treatments This information has been kindly provided by Rebecca Randerson, a Wellington GP. MEDICATIONS - SYSTEMIC ( Not topical – usually medication taken by mouth) ANALGESICS Analgesics are pain medicines. These are sometimes given as temporary relief if your pain is severe, while waiting for other treatments to begin working. Some analgesics have side effects and some can be addictive. Your doctor should discuss this with you before prescribing the painkillers. ANTIDEPRESSANTS Medications in this group have different uses at different doses. Lots of “ antidepressant” medications only have their antidepressant effect when used at higher doses. Sometimes this may be required. However, more frequently, these so called “ antidepressant “ medications are used at a lower dose to alter the way your body senses pain. They can reduce the transmission of pain sensation through the nerves and are very useful at reversing the vicious cycle of pain that can occur. They can help to permanently calm down the over-sensitive nerves in the vulval region. These medicines work slowly over time so need to be continued for several months to have their effect. ANTIHISTAMINES These medicines reduce itchiness and allergy. Some of them can make you feel slightly sleepy – discuss this with your doctor. ANTI-INFLAMMATORIES Inflammation is your body reacting to something that irritates it. Generally the area appears angry - such as redness, swelling and itch in the vulval area. Anti-inflammatories can reduce the over-reaction of the vulval area and improve symptoms. Some people can get stomach problems from some anti-inflammatories but there are very many types and there will probably be one that is suitable for you if required. ANTI-FUNGALS This name applies to a group of medicines used to treat fungal and yeast infections of the vulva and vagina. Almost always, this is due to the ‘candida’ bug, commonly known as thrush. Initially treatment is topical – ie applied directly into the vagina, but sometimes this is not enough to stop thrush from coming back again and again. In this situation, your doctor may discuss giving you strong anti-thrush tablets by mouth. Sometimes these need to be taken for several months in a row – depending on how severe the thrush problem has been. There are some side-effects of these medicines so discuss this with your doctor. ANTIVIRALS A specialist would need to be consulted regarding this option. GUAIFENESIN A specialist would need to be consulted regarding this option. HORMONAL TREATMENTS Some vulva problems appear because of an imbalance of hormones in the body. Hormones help keep the entire female genital tract healthy. Discuss with your doctor if you think you have other symptoms of hormone imbalance or menopause. For instance: dry vagina, dry skin, heart racing, hot flushes or cold sweats, mood swings, headaches. Sometimes your doctor can prescribe hormone medicines when your body is having trouble adjusting to changes in its hormones. In some women these are not considered safe such as those who have had previous breast cancer, or who suffer from severe or unusual migraines – discuss this with your doctor. Treatments in this group may be in the form of tablets, patches that stick to your skin or cream that is rubbed into your upper body. MEDICATIONS - TOPICAL It is helpful to be aware that any treatment applied directly to the vulva can cause irritation in a small number of women. This is unpredictable. If any cream that is applied to the vulva seems to make things a lot worse, you should stop using it and discuss it with your doctor. ANAESTHETIC CREAMS These creams can be rubbed onto the vulva/vagina and make the area numb for 30 – 60 minutes. They can reduce pleasant sensations as well as pain so should only be used on the painful areas. These are harmless medications that can provide some relief eg to allow intercourse without pain. HORMONAL CREAMS Mostly these are applied directly to the vaginal area to improve the lushness of the area. Because these are only applied directly to the area, they only act in the local area so do not affect the entire body. STEROID CREAMS Steroids are chemicals that are released naturally by our bodies ( from the adrenal glands). Steroids are released whenever our bodies are stressed and help calm down angriness in the body. They have anti-inflammatory effects ( see above ) but have a much wider range of other beneficial effects also. They are not the type of steroids that some athletes take to alter their physique and the only real negative effect that they can have is that they can thin the skin if used for prolonged periods eg months and months on end. Also, if used while there is a thrush infection present, they can make the thrush much worse so this should be checked for and treated beforehand. There are many different strengths of steroid cream and often vulval problems require quite strong creams to work well. These can be very effective. Discuss with your doctor how much to apply and for how long. Sometimes these can sting temporarily eg for 10 minutes when first applied. ANTIFUNGAL CREAMS See above under antifungal medication |