The most common complaint that women go to the gynecologist is a complaint about “bad discharge” and ” discomfort in the genital area.” As standard, this is followed by a full examination, including smears, tests for hidden infections, blood tests, etc., in General, everything that the doctor’s imagination is enough for. Often, the tests find minor deviations from the norm and on the principle of ” it is necessary to treat something, prescribe antibiotics, candles, douching. The effect of such treatment is unstable, and the patient again appears at the doctor with the question ” What to do?”, since the treatment did not help. Next, new tests, treatment, disappointment in the doctor, change of doctor, etc.
One of the relatively new diseases is vulvodynia. It is characterized by pain and discomfort of various types in the area of the vagina or perineum.
Life begins to revolve around these feelings, which can destroy sexual life, develop neurosis and deep depression.
In fact, quite a few gynecologists have not even heard of such a disease as vulvodynia. It was described relatively recently, and, according to various data, vulvodynia is diagnosed in 16-18 % of women. The main manifestation of vulvodynia is pain of various types and intensity in the area of the entrance to the vagina or perineum (these are two different forms of the disease). Pain can be cutting, burning, itchy, stabbing, in General, very different. They occur after sexual intercourse, insertion of a tampon, prolonged sitting, wearing tight-fitting underwear, Cycling, etc. In some cases, the occurrence and maintenance of pain is not associated with anything.
Vulvodynia affects about 16-18 % of women. It is assumed that one of the reasons is the incorrect operation of nerve endings, making the perineal area hypersensitive.
No one knows why this disease occurs. It is assumed that the basis is the incorrect operation of the nerve endings, leading to increased pathological sensitivity of this zone. This phenomenon is also compared to phantom pain in an amputated limb. It is also suggested that the cause of vulvodynia may be trauma (mechanical or chemical), hypersensitivity to Candida fungi, muscle spasms, etc.
The diagnosis is made on the basis of the absence of inflammatory diseases in this area (good tests), and a test with a cotton swab is also used, in which gentle touches of this stick in the area of the entrance to the vagina cause unpleasant painful sensations.
Often, having such symptoms, women begin to be critical of their secretions and are fixed on the fact that they have a constant inflammation that no one can detect and cure completely.
Of course, the suspiciousness of patients plays a role, but sometimes it is provoked by the doctors themselves. It is no secret that some doctors update the patient, indicating the presence of minor diseases and insistently demanding their treatment. Here are some examples.
Small condylomas in the vulva area are not dangerous, they can be removed at will, they can disappear on their own. In practice, they are often removed (mucosal injury), then they appear again, again removal – everything, the patient is in constant attention to this area, and any sensations “from there” give cause for alarm.
White blood cells in the smear-normally, the number of white blood cells in the smear varies depending on the phase of the cycle and for a number of reasons. To say that there is an inflammation, only on the basis of an increased level of white blood cells is impossible, but they say and treat these “white blood cells” for years.
And of course, treatment of ureaplasmas and mycoplasmas – an asymptomatic patient against the background of full health tries to get rid of the “terrible infection”with the help of heavy antibiotics and other additional means. Many are treated for years for several courses, convincing that it is necessary to get rid of it.
The number of white blood cells in the smear directly depends on the phase of the cycle.
Against this background, there are patients with perfect tests, but constant complaints of “discomfort and discharge”.
when examined, they have perfect discharge, but they do not believe and ask to take more tests. They were not told how the discharge changes during the menstrual cycle:
• at the beginning of the cycle after menstruation, they are scarce;
- closer to ovulation, they become like egg white, stringy and transparent;
• after ovulation-as if milk was added to the discharge •
- closer to the monthly period, there may normally be lumps, light itching and a sour-milk smell.
And this is all the norm!
No one tells these patients that there can only be a few diseases in the vagina.
- Candidiasis vulvovaginitis (thrush) – bright white curd discharge with severe itching, sharp redness and swelling of the mucosa.
- Bacterial vaginosis – white creamy discharge with a characteristic fish smell.
- Aerobic vaginitis – yellowish discharge, sometimes with a sweet smell.
- Trichomoniasis-foamy discharge with severe itching.
Bad discharge causes 4 diseases: thrush, bacterial vaginosis, vaginitis and trichomoniasis.
That’s it! That is, the doctor can’t give you anything other than these diseases. There is no diagnosis of “you have inflammation there”.
The third important point: the appearance of yellowish discharge does not always mean that there is inflammation. Getting a small amount of blood into the vagina (for example, during ovulation) can change the color of the discharge to yellowish due to the oxidation of blood in an acidic environment, or rather iron, which is part of hemoglobin. Remember: an Apple turns yellow and brown after you bite it and leave it in the air.
Ignorance of these factors leads to excessive treatment of non-existent diseases and conditions, as well as increased anxiety and acute sensations in the genital area. In my opinion, this is one of the most common reasons for the formation of vulvodynia in our country.
No effective treatment for vulvodynia has been invented. I use antidepressants, local anesthetics, anticonvulsants, nerve block, and so on. The most effective, as I described above, can be psychotherapy using hypnosis.
Remember! There is no diagnosis of “you have inflammation there”. If the doctor says these words to you, it may indicate their incompetence in this matter.
The problem is really serious, almost nothing is known about it in our country, although many women suffer from it.
Prevention can be done by informing women about the presence of such a problem at an early stage, as well as knowing the three facts about vaginal discharge and diseases that I listed above.
