The VPAC provides a thorough multidisciplinary assessment for women experiencing chronic vulvar pain. Following an appointment with a gynaecologist, pelvic floor physiotherapist and psychologist the individual biopsychosocial factors contributing to the patient’s pain experience are identified. A treatment plan is then developed with the patient using a shared decision-making model of care. We assist the patient with implementing this treatment plan in the community setting with the referring physician. Our clinic does not provide long term care.
What is vulvodynia?
Vulvodynia refers to vulvar discomfort or pain of at least 3 months’ duration, without a clear identifiable cause for the pain. Approximately 16% of women experience this type of vulvar discomfort and or vulvar pain at some time in their life. Vulvodynia may be either generalized to the entire vulva (termed generalized vulvodynia) or localized to specific areas of the vulva (e.g., the clitoris – termed clitorodynia; the vulvar vestibule – termed vestibulodynia). Further, the pain or discomfort may be either provoked (i.e., occurring only when the area is touched such as during sexual activities or gynaecological examinations) or unprovoked.
What are the symptoms?
Women experience uncomfortable sensations such as burning, stinging, irritation, stabbing, or rawness. The discomfort may be mild or severe. Some women find the symptoms very distracting and report that the symptoms interfere with daily living activities (wearing clothes, sitting, or walking) and/or sexual activities.
How is vulvodynia diagnosed?
The diagnosis of vulvodynia is based primarily upon a women’s history and a thorough clinical exam of the vulva and vagina. No special investigations and or tests are usually needed.
How do you treat vulvodynia?
There are many different therapies and treatments available for women suffering from vulvodynia including medical, behavioral, and surgical treatments. Women will often need to try several different treatments before experiencing significant pain relief. The longer a woman has been experiencing pain, the more likely that she will benefit from a multidisciplinary approach to treating her pain.
National Vulvodynia Association has a Self Help Guide which you can access here. Other resources can be found here.
Watch our online Education Forum for an overview of the treatment approaches introduced in the Vulvar Pain Assessment Clinic.
Your Journey through the Vulvar Pain Assessment Clinic
Initial Assessment: Your first appointment will be with a gynaecologist. This hour-long session will include a discussion and a gentle physical exam. We will review your medical and pain history in detail, including the impact of pain on your daily activities, relationships and sexual health.The physical exam will rule out other causes of vulvar pain, such as infection or a skin condition.
You will then meet with the Clinical Coordinator who will guide you through the remainder of the assessment process.
Psychologist: Psychosocial factors, such as anxiety, can contribute to vulvar pain. in some women these factors can also be exacerbated by the pain. In many women, sexual pain has an impact on their sexual self-esteem and relationship. your one hour appointment with the psychologist will explore these factors and determine to what degree to they contribute to your pain. Virtual appointments are an option.
Pelvic Floor Physiotherapist: Women who experience chronic vulvar pain will likely have increased tension in the pelvic floor muscles. During your one hour in-person appointment with the physiotherapist biofeedback will be used to increase your awareness and conscious control of the tightness of these muscles.
Treatment Planning: Following the three assessment appointments you will meet with a gynaecologist to develop a longterm treatment plan. virtual option is available. At this appointment, you will have the opportunity to identify your treatment goals, discuss what you have learned, what treatments you feel will be of the most benefit going forward, and the next steps/plans to pursuing these treatments. We will provide you with resources within the community to implement this plan. A summary of this discussion is then forwarded to you, as well as the physician who will be resuming your ongoing care. Your are encouraged to meet with their providers to review their progress and make plans for ongoing care in the community.