vulvodynia treatment with acupuncture
Vulvodynia is a medical condition characterized by nonspecific vulval pain.With up to 15% of women suffering from this condition, you can be sure that you’re not alone if you have vulval pain. It is a persistent burning or stinging pain of the vulva. It could be a constant pain and get worse when under pressure or it could be only painful under pressure such as using tampon or sex. The pain can be only in the vulval area. It can also spread to the thigh, tummy or back. Women with vulvodynia could have severe period pain, heavy periods, frequent urination and pain and changed bowel habit. Before vulvodynia is diagnosed, other causes of vulvar burning must be excluded. These include fungal, bacterial and viral infections, inflammatory dermatoses such as lichen sclerosus and lichen planus, contact sensitivity and eczema, and lesions such as surgical scars and recurrent fissuring. Vulvodynia can affect women of all ages. The possible causes of vulvodynia may include nerve irritation, abnormal response in vulvar cells to an infection or trauma, genetic factors that make the vulva respond poorly to chronic inflammation, hypersensitivity to yeast infections, muscle spasms, allergies or irritation to chemicals or other substances, hormonal changes, history of sexual abuse, frequent antibiotic use. This condition is not life threatening, but it has great impact on a women’s life physically and emotionally. It could affect their daily activity and relationships. Some of them can only stay in bed all the time when the pain is severe. Some women with severe vulval pain feel that it is so difficult to cope with this pain every day especially when they are told that there is no effective treatment and they have to live with the pain all of their lives.
Acupuncture can help treating the vulval pain. In 1999, JOURNAL OF THE ROYAL SOCIETY OF MEDICINE published a paper by Powell and Wojnarowska about acupuncture for vulvodynia. They selected twelve patients with vulvodynia aged from 18 to 68 years. All had vulval pain and burning without other abnormalities on examination. All had experienced severe distress and impairment of sexual function. Many had tried suggested treatment without success. These patients were offered weekly acupuncture for ten weeks. As a result of acupuncture, Two patients felt so much improved that they declared themselves 'cured'; three believed their symptoms had improved and wished to continue acupuncture; four felt slightly better and judged acupuncture more effective than any other treatment; and three noted no effect at all. There were no obvious side effects for the treatment. A study from Sweden investigated the effect of acupuncture on vulva vestibulitis. They found that after three month acupuncture treatment patient’s quality of life was improved significantly. More recently Curran et al were using acupuncture for treatment of provoked vestibulodynia which is also a genital pain condition. There were 80 patients involved in this study. After 10 treatments there were significant decreases in pain with manual genital stimulation and helplessness. There were also strong effects for improved ability to have intercourse and sexual desire. Qualitative analyses were overall more positive and showed an improvement in perceived sexual health, reduced pain, and improved mental well-being in the majority of participants. A new research from Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA has shown that acupuncture treatment significantly reduced vulval pain in women with vulvodynia. In this study, thirty-six women with vulvodynia were involved. The women were randomly assigned either to the acupuncture group or to the wait-list control group. 10 sessions of acupuncture were offered to women in acupuncture group. Reports of vulval pain and dyspareunia were significantly reduced, whereas changes in the aggregate FSFI scores suggest significant improvement in sexual functioning in those receiving acupuncture vs. those who did not. Their conclusion is that this was the first randomized controlled pilot study to examine the use of acupuncture for the treatment ofvulvodynia. The acupuncture protocol was feasible and appeared to reduce vulval pain and dyspareunia with an increase in overall sexual function for women with vulvodynia.
These are example cases that were treated with acupuncture successfully
A 34 year old lady had vulval pain for 3 years. The pain is worse when pressure is applied such as having intercourse. She always had very painful periods. There was tightness in her thigh and back. She was treated with antidepressant and physiotherapy, but the pain has not improved. There was no pain when passing water and no change with bowl habit. She decided to try acupuncture. After 8 acupuncture treatments, the pain was reduced significantly and she was able to stop taking antidepressant.
A 29 year old lady had vulval pain for 2 years. There was burning sensation when passing water with frequent urination. The vulva pain was unendurable when having intercourse. It was impossible to use tampon. She also had lower back pain. Her periods were very painful. She was treated with various medications, but the pain was not improved at all. She has heard from a friend that acupuncture can help with her condition and decided to try it. After 3 month treatments, the pain has completely gone. There was no pain when passing water and no intercourse pain.
A 43 year old lady had severe vulvar pain for 1 year accompanied with period pain and intercourse pain. She had irregular periods and she also had frequent urination and urgency. The pain goes to lower abdomen, thigh and lower back. Antidepressant and local injection of steroids did not have any improvement. After 5 treatments the pain was less and another 10 treatments, the pain was completely disappeared.
Powell and Wojnarowska J R Soc Med (1999) 92:579-81
Curran S et al J Sex Med (2010) 7:981-95
Danielsson L et al Acta Obstet Gynecol Scand (2001) 80:437-41
Schlaeger JM et al J Sex Med (2015) 12: 1019-27
Chronic pelvic pain which is continuous or episodic pain in the lower abdomen or pelvis lasting at least three to six months is one of the most common pain conditions experienced by women. It has great negative impact on women’s quality of life including constant physical and psychological aspects. Recently a study from the US has shown that most women who used acupuncture (91%) had at least some improvement in symptoms based on self-report.
Chao et al Pain Med (2015) 16:328-40