A Review of “Bridging the Gap in Care: A Call for Interdisciplinary Guidelines on Vulvar Pain Disorders”
Here at the Vulva Pain Clinic in London’s Harley Street, our world-class Vulva Doctors are internationally renowned for their continuous drive to enlighten people about the extremely difficult and painful condition known as Vulvodynia. Moreover, we all support Interdisciplinary Guidelines on Vulvar Pain Disorders, and are unanimous in that awareness is absolutely vital for early vulva pain diagnosis, suitable treatment, and ameliorating the quality of life for those who are impacted. – Some of whom describe their condition as akin to having a red hot poker stuck up their private region.
Now finally, primarily thanks to our clinic’s pioneering Pain Doctors, along with others in the US, countless women who have been living the daily nightmare of suffering in silence with unbearable pain, and the knock-on physical, sexual, emotional health, and relationship issues, have the opportunity to turn their lives around.
Of note, our renowned Pain Specialist, Dr Christopher Jenner, MB BS, FRCA FFPMRCA, and his team of experts (including top practising physicians, pelvic physiotherapists who specialise in vulva pain, health scientists, and more) – all of whom have a long history of empowering women to overcome their chronic vulva pain through focused Management Strategies and our patient-centred Holistic Personalised Treatment Plans (which comprise both conventional, and the latest state-of-the-art treatments, pharmaceuticals, therapies and injectables), have released a winning book (via Amazon and other leading book stores), entitled Viva la Vulva, a name which suggests having success at overcoming vulva pain disorders. Moreover, all of our Vulva Doctors are available for online or in-person consultations.
Did You Know?
“According to the National Vulvodynia Association, as many as 16% of women experience this condition at some point. Some have pain only during penetrative sex or when using tampons; for others, it is far more severe – their discomfort is such that they can barely sit down. The pain itself is sharp and searing, and can range from giving the same sensation as severe thrush to feeling as if something inside you has been torn” [1]
AUA News Article on Interdisciplinary Guidelines For Vulvar Pain
In this highly informative article published by the American Urological Association (AUA), the authors, Aurora J. Grutman, BS, John Hopkins University School of Medicine; and Maria Uloko, MD, MUMD Sexual Medicine Counseling, Los Angeles, California, note that within the sphere of medicine, where every disorder competes for attention: “there exists a silent struggle faced by countless individuals grappling with vulvodynia. The debilitating pain associated with this condition permeates patients’ lives, overshadowing daily activities and intimate moments. Yet, the path to diagnosis and relief remains fraught with challenges, largely due to a dearth of understanding among health care providers and the absence of unified guidelines for the diagnosis and treatment of vulvar pain” [2].
This aforementioned scenario is most definitely the case in the UK, where many GPs seem unable to help sufferers, many of whom find it difficult to discuss their condition due to embarrassment and the fact that vulva issues have for many years, been regarded as taboo. Moreover, very few GPs have undergone the necessary substantial years of training and clinical experience of that of a Pain Doctor or Vulva Doctor. – And this lack of expertise can result in an inaccurate diagnosis, poor treatment, and continual suffering, as opposed to being given a highly accurate diagnosis, and a state-of-the-art cutting-edge treatment plan, which is regularly reviewed, and when necessary, adjusted according to the patient’s progress and needs.
The Low-Down on the Reality of Vulvodynia
Vulvodynia, as discussed by Grutman and Uloko, can be described as a excruciating, exhausting,vulva condition that can prevent sufferers from getting the most from their lives. Moreover, they can experience countless issues including:
- Feeling at their optimum
- Engaging in sexual intimacy
- Working in an optimal way
- Being able to stand up, and
- Being able to sit down [2]
- Being able to wear certain clothes
- Being able to insert a tampon
- Being able to use certain personal products such as standard shower gel
Conflicting Professional Guidelines & Inadequate Training of Health Care Providers
Due to these two aforementioned aspects in the title, sufferers (including many women in the UK), could be suffering the fall out of untreated vulvodynia for years, or even their entire lives. To that end: “new diagnosis and treatment protocols developed by an interdisciplinary council, are necessary to address this important but overlooked health issue” [2]. And there is more: in the US (where the situation could well be compared to the UK), they collect statistics, and: “of those who do seek help, 60% leave physicians’ offices without a diagnosis or relief [2].
Highlighting the Systemic Issues Within Medical Education
The current clear and present dangers of inadequate treatment and the under-diagnosis of vulva pain, derive from general issues within the education of medics in the UK, the US, and other parts of the world. Of note, and inline with the view of our Pain Doctors at the London Pain Clinic, the constant stigma around the female genitalia and reproductive organs, and the lack of knowledge on the anatomy of the vulva, play a strong role in health care professionals’ ignorance regarding vulva issues. Indeed, as the authors of the news article, note, this: “blinkered approach in academic training, where pelvic examinations focus disproportionately on reproductive organs, only further sidelines crucial components of sexual health” [2]. Indeed, a survey which was undertaken, highlighted the fact that only 40% of gynecologist/obstetrician clerkship directors stated that their training in pelvic examination was of a high standard. Furthermore, sexual health is frequently eclipsed in the sphere of women’s health [2].
Addressing the Issue of Giving Vulva Pain the Necessary Recognition
Aurora J. Grutman and Dr Maria Uloko have put forward a proposition to set up an interdisciplinary council which includes of experts from appropriate medical fields. These comprise:
- Physiotherapists (who just as with our Harley Street’s Pain Clinic’s vulvodynia physiotherapist who specialises in pelvic health), play a crucial role in ameliorating vulvodynia)
- Dermatologists
- Psychologists
- Urologists
- Gynecologists and
- Obstetricians [2]
Furthermore, this interdisciplinary council should be directed to develop cooperative joint guidelines on:
- Undertaking pelvic examinations
- Providing accurate diagnosis, and
- Treating vulva pain [2]
Moreover, the authors of the proposal note that by drawing in a united collaboration of experts in diverse disciplines, comprehensive guidelines can be generated, and these can revolutionise the care paradigm for vulvodynia – an often unbearable condition which impacts so many women. Indeed,
“the time has come for a transformative approach, one that ensures safe, timely, and effective treatment for those affected by vulvodynia” [2], and here at the London Pain Clinic, all our renowned Pain Doctors advocate the same transformative approach to ensuring that all vulvodynia patients receive an accurate diagnosis, and first-class innovative and cutting-edge treatments, therapies and injectables. – Some of which patients can have simultaneously in order generate a synergy that can help them get their lives back on track as soon as possible.
References
[1]. O’Neill, L. (2019). “It was like a red-hot poker’: why the extreme pain of vulvodynia is going untreated.” The Guardian.
[2]. Grutman, A.J, & Uloko , M. (2024). “Bridging the Gap in Care: A Call for Interdisciplinary Guidelines on Vulvar Pain Disorders.” AUA News.