Devotees of Sex And The City will probably remember the iconic episode where Charlotte proclaims she has a depressed vagina.
To Carrie and Miranda’s bewilderment, their gal pal emotively explains over lunch she’s been diagnosed with vulvodynia, for which her gyno unexpectedly prescribed her an antidepressant, and asked her to chronicle her symptoms.
“Every day I have to keep a vagina journal,” she explains.
“A “Dear Vagina, why so blue?” kind of journal?” Miranda mocks.
But despite its comical depiction in the show, vulvodynia is no laughing matter.
Charlotte’s depressed vagina brought some much needed attention to a serious health condition that affects roughly 16 percent of women, mostly between the ages of 18 and 25, though more mature women aren’t immune.
Though it’s far less well known, vulvodynia is more common than endometriosis and breast cancer. Its biggest PR problem? Up until recent decades, the condition was largely regarded as a problem that only existed in a woman’s mind.
“Women have gone to the doctor with symptoms, the doctor has found the vulva looks quite normal, and women have been labeled as psychologically disturbed,” says Vulva Disorders Unit at the Royal Women’s Hospital in Melbourne director, Dr Ross Pagano.
Even today, it’s extremely difficult to diagnose vulvodynia. There’s no specific test — the only reliable means of determining its existence is to rule out alternative conditions like thrush or eczema. It’s a process of elimination not all doctors are as familiar with, which is why the average sufferer visits as many as seven different doctors before she gets the correct diagnosis.
The consequences ofvulvodynia can be devastating; physically, mentally and emotionally. Its a health issue that has far-reaching and profound effects on everything from a woman’s intimate relationships to her career and self-esteem; so it’s time to talk about it and have a serious look at the signs and symptoms…
1. It itches.
Before finding out her vagina was depressed, SATC‘s Charlotte thought she had a yeast infection. This misdiagnosis isn’t uncommon, as one of the hallmark signs of the condition includes itchiness; a typical side effect of thrush.
So how can you tell the difference between a thrush outbreak or a case of vulvodynia, then? Look at your discharge. If it’s thick, white and cottage cheese-like, it’s probably a yeast infection. But if things look as peachy as ever downstairs, and you’re madly itching, it’s likely to be a vulvodynia-related nerve problem.
Surprisingly, the prescription for an antidepressant is a common solution to this uncomfortable symptom.
“It’s not clear why antidepressants work for some women, but they do,” says OBGYN, Sherry Ross, M.D.
2. It burns.
Vulvodynia is also known as ‘Burning Vulva Syndrome’, for good reason. A burning sensation is the most common symptom, and can range in extremity from a little stinging, to being described as “having acid poured on my skin” or constant, shooting “knife-like pain”, as in the words of diagnosed patients.
Seventy-five per cent of women with vulvodynia attest to feeling ‘out of control’ in their bodies due to this painful symptom, which often occurs without any other associated symptoms and at completely random times, making it near impossible to properly investigate, and incredibly frustrating for the sufferer.
3. It’s sore
For some vulvodynia patients, the vulva can feel constantly sore. It may be a general aching throughout the day, or a more acute throbbing pain brought on by sex that lasts for several hours afterward.
Sometimes specific parts of the vulva may additionally become inflamed and swollen, though more often than not, things will appear ‘normal’ for sufferers, despite intense bouts of pain and discomfort. This is the main reason why vulvodynia is so difficult to diagnose. It’s a nerve condition, not a skin irritation, infection or sexually transmitted disease. So when a doctor does an initial examination, everything may come back clear. But if soreness persists for more than a couple of weeks and tests don’t turn up results, it’s a surefire sign you should seek the advice of a specialist well-versed in vulvodynia, like a gyno.
4. It’s sensitive.
The vulva is already a sensitive area. There are a lot of nerve endings down there, which is the whole reason why sex feels so good. But the type of sensitivity that comes from vulvodynia is not helping any lady get laid.
With vulvodynia, the nerve endings are usually damaged or irritated and go into overdrive, hence the feeling of being on fire. But it can also feel raw and hypersensitive to anything touching or rubbing around the area. This automatically cancels out all exercise (especially spin class). Forget about tampons and chunky pads; or even pants and underwear for that matter. Some women even struggle to sit down for a long period of time, causing them to quit their jobs. A depressed vagina can literally lead to becoming a depressed person when the symptoms are severe.
5. Chronic pain.
There isn’t one known cause of vulvodynia, or a set amount time for how long it lasts. It can drop in unannounced, and stay forever or may come and go temporarily. What is certain though, is that it will hurt for as long as it hangs around, so it’s essential not to ignore the symptoms and seek treatment as soon as you notice something’s up.
There is some proof that a woman is born with more nerve endings in between her legs, and if they become damaged – whether through sex, childbirth, or exposure to various vaginal infections – it can trigger this condition.
“It’s known that women who get vestibulodynia – the commonest form of vulvodynia which occurs just inside the vagina – are born with a much higher concentration of nerve endings in the vulva vestibule than the average woman,” says Dr Pagano.
6. It can hurt all over.
Another reason why vulvodynia can be so difficult to diagnose is because it doesn’t always hurt in one spot (much less the same spot) for all women.
For some, the pain is localized to just the vagina, but for others, the entire vulva region hurts. But it doesn’t just stop there. Patients have reported the symptoms affecting areas ranging from the clitoris to the anus, and even the inner thighs.
7. Painful sex.
There aren’t many things more depressing than not being able to sex, or have it at all. It’s a basic part of human life. But for women with a depressed vagina, sex avoidance can become a grim reality.
“Most of the patients I see can’t have intercourse at all, and many have not for years,” explains Dr Pagano.
Ironically, one of the best ways to prevent vulvodynia is with sex, according to OBGYN and medical director of Women’s Healthcare of Princeton, Maria Sophocles, M.D.
“Sex promotes healthy collagen and elastin cells, and maintains the flow of blood to the area.”
If these symptoms sound too familiar to you, it’s time to get it checked out. If not, it’s time to get busy to keep your hoo-hah happy, not depressed.