Assessment and management of vulval pain

David Nunns, Ruth Murphy
In: BMJ · 2012 · vol. 344(mar28 1) , pp. e1723 · doi:10.1136/bmj.e1723 · PMID:22457438 · W1965105498
review OA: closed CC0 ⤵ 2 in-corpus citations
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This review addresses the assessment and management of vulval pain, differentiating between pain with a specific cause and idiopathic vulval pain and discussing diagnostic challenges due to varied patient symptom descriptions.

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Abstract

#### Summary points The vulva refers to the female external genitalia comprising the mons pubis, clitoris, labia majora, labia minora, and perineum (figure⇓). Vulval pain can be divided into two categories: pain secondary to a specific, identifiable, underlying disorder and idiopathic pain with no recognisable underlying disease. Women use the term pain to include a variety of unpleasant symptoms including burning, soreness, and throbbing, and some women insist that they do not have pain but describe the sensation with one of these words, which can be misleading for clinicians. Fig 1 Normal vulval anatomy #### Sources and selection criteria We searched for papers that had been published up to August 2011 using appropriate index terms (vulval pain, vulvodynia, vestibulodynia, lichen planus, and lichen sclerosus) from the National Library computerised search service (Medline, PubMed). Most studies were observational but a few randomised controlled trials were available. The exact prevalence of vulval pain in adult women is not known, but a recent population based survey from the United States found that 16% of women had at some time experienced chronic burning, knife-like pain, or pain on contact with the vulva that …

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License: CC0 · commercial use OK