A woman is diagnosed with vulvodynia when her symptoms of pain have lasted for at least 6 months and when other causes of vulvar pain (i.e. vulvovaginal infections) have been ruled out.
Diagnosis can also involve biopsy of any questionable areas, which is when a small piece of tissue is cut out for microscopic examination. Vulvovaginal infections can be ruled out by testing for fungus, trichomoniasis, chlamydia, gonorrhea, or bacterial infection. A doctor can test for yeast infection by examining vaginal secretions microscopically for the presence of yeast forms. Chlamydia can be tested for when a clinician sends a sample of vaginal secretions to a lab that can look for the bacterium Chlamydia trachomatis.
Gonorrhea is diagnosed through gram stain, detection of bacterial genes or DNA (from the bacterium Neisseria gonorrhoeae), and culture. Gram stain involves smearing a sample of vaginal secretions on a slide and staining it with a dye. This will show whether or not the bacteria is present. Secretions can also be analyzed for presence of the genes of the bacteria. Culture involves incubating a sample of the vaginal secretions to allow the bacteria (if present) to multiply.
A variety of factors need to be considered to make an accurate diagnosis of vulvodynia. Initially, it is important to take a careful medical history. In particular, one should look for an initiating factor such as surgery, childbirth, or change of sexual partner.
Other factors to explore are a relationship between vulvodynia and the menstrual cycle; urethral symptoms; other medical conditions; any medications used ( past or present); any family history (other female family members who have experienced similar symptoms); the use of menstrual pads or panty liners; trauma to the perineum from excessive exercising or bicycle riding; and contraception use.
The following tips may help you manage the symptoms of vulvodynia:
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