Vulvodynia - A contemporary understanding and practical approach in primary care settings

外阴疼痛——基层医疗机构中的当代理解和实用方法

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Abstract

Vulvodynia manifests as persistent vulvar pain, affecting both sexual well-being and overall quality of life. While the precise cause remains elusive, various multifaceted predisposing and precipitating factors have been identified. Neurobiological and psychosocial elements contribute to a better understanding of the management of this complex disorder. Initial evaluation with detailed history-taking and focused pelvic examination are essential to exclude organic diseases contributing to vulvar pain. Management strategies are based on clinical experience, including non-pharmacological approaches and cognitive behavioural therapy. Oral pain-blocking medications such as serotonin-norepinephrine reuptake inhibitors and gabapentin as well as topical treatments such as oestrogen, lidocaine and gabapentin may be considered. More robust evidence is required for pharmacological treatments. Referral to a multidisciplinary team may be required in a proportion of patients who do not respond to conventional treatment. This concise review highlights the contemporary understanding of vulvodynia and proposes a practical approach within primary care settings.

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