Vulvodynia and what to expect with acupuncture
What is vulvodynia?
Vulvodynia is a chronic pain condition characterised by pain and potentially a burning sensation in the female genitals, specifically of the vulva, and entrance of the vagina. The pain is often brought on when pressure is applied to the area, such as with bike riding, sitting for prolonged periods, and sexual intercourse. In my work with gynaecologist Dr Clare Myers, I have found an increasing number of patients presenting with the condition. Unfortunately, conventional treatment is often lacking, and largely relies on pain killers and avoidance of activities that exacerbate the symptoms. As intercourse is generally very painful for women with vulvodynia, this creates stress and tension in relationships. Many women tell me they have become afraid of having sex and do not know how to break the cycle of pain. While counselling for some women is very helpful, others feel that the pain they are experiencing has a physical cause.
Is acupuncture effective for vulvodynia pain?
A study in the Journal of the Royal Society of Medicine [insert link] looked at the effects of acupuncture on vulvodynia patients. Of the 12 participants in the study, 2 patients felt such relief from their symptoms after a few sessions they declared they felt 'cured', 3 felt their symptoms had improved and wanted to continue with regular sessions, 4 felt slight improvement which they still felt to be more effective than any other treatment they had tried, and the remaining 3 felt no difference.
From my perspective, this study is also interesting, as the point selection is quite rudimentary, and yet, still yields good results. In my clinical practice, I consider the patient's presentation of symptoms, and vary the points used to adapt to the case and maximise outcomes.
Where will needles be inserted?
Acupuncture for vulvodynia does NOT require any local needling around the genitals. I mostly use points on the arms and legs in a technique called 'distal acupuncture' so patients can remain fully clothed. There are some points around the knee and lower thigh region we may use, so if the patient is wearing tight jeans or stockings, these may need to be taken off, but a towel will be left on the table for them to drape over their waist in privacy before the session begins.
What outcomes can I expect?
Generally, the longer you have had the issue, the more sessions we need to relieve symptoms. I maintain strong communication throughout the sessions, to ensure that we are on track with the patient feels a difference in their complaint and a relief of pain. As a rough estimate from my clinical experience, I suggest that for a relatively acute condition where the patient has had symptoms for less than one year, we require between 5-8 sessions. For patients with long-term vulvodynia pain for over 5 years, we usually require between 10-20 sessions. If after 3-4 sessions the patient has not noticed any difference in their symptoms, I may suggest an alternative treatment and practitioner for them, such as a pelvic physiotherapist or counselling if necessary.
LET’S CONNECT
Naomi Jankowski is a Chinese Medicine practitioner working in Melbourne, with special interest in the use of Tung acupuncture for pelvic pain management.