Vulvodynia- The unspoken disease of millions of women

On August 7, 20/20's Medical Mysteries presented a segment on painful sexual intercourse moderated by Dr. Timothy Johnson, ABC's chief medical editor. Through the course of interviews with 2 medical exerts and 3 female patients Dr. Johnson presented the deleterious impact of vulvo-vaginal diseases on the lives of patients and their families. While some critics of the program complained that the medical conditions vulvodynia and vulvar vestibulitis were not identified and the sexual nature was emphasized to the exclusion of all of the other health problems these diseases cause, this was a major step forward for the television communications industry in recognizing female health issues. Many of these health problems which include vulvodynia, vestibulitis, and yes, even breast cancer are a source of shame and ignorance among women.

During the 1970-1980's I administered a vulvodynia clinic which I ran through my dermatology practice. In contrast to the literature approximately 80% of the patients were able to obtain some relief and less than 20% went into remission. Vulvodynia is a disease characterized by chronic burning and itching of the vulva and when it involves the opening of the vagina it is often called vaginal vestibulitis. Often these symptoms are not associated with easily observed clinical disease and patients seek doctor after doctor with increasing frustration and absence of improvement. While these symptoms are often attributed to subclincial disease, the release of immune mediators in the skin, and to neuroses, there are a number of conditions which can be identified as the cause of the disease and which are treatable. Among these are eczema, a chronic itching disease of skin; lichen planus, an autoimmune skin disease; lichen sclerosis, a potentially precancerous disease of the skin and mucosa; contact dermatitis, an irritant or allergic reaction to chemicals; yeast and fungal infections; vaginal discharge; precancerous and cancerous skin lesions; and senescent tissue atrophy from loss of estrogen. In addition chronic pain syndromes which include vulvar pain syndromes may be treatable.

After speaking with Dr. Mia Song, a gynecologist and my partner Dr. John Rachel's wife, I learned that this area of women's health is still woefully under served. For that reason I have resurrected a vulvodynia program within our practice at MetropolitanMD.

Visit our website to learn more about vulvodynia. You can view the 20/20 segment online at http://abcnews.go.com/2020. Under August 7th click on "Millions of Women Find Sex Unbearable". You may also go to the website for National Vulvodynia Association.