Vulvodynia, Cristina’s story

DEKA Intimate - IntimateStory Cristina

At the beginning of 2021 I started to have strange burning pains. In the past, like many of us women, I had suffered from similar ailments.

Cystitis from bacterial infections that with a classic Monuril treatment went away, or that following a positive urine test with some antibiotics resolved the problem.
But this time there was no infection in my urine. I wanted to wait. I thought to myself, ‘maybe it will pass…now it will pass…’ but the burning in my private parts would not go away this time.
At times, and more so than in the past, anal and pubic pains would occur, like pins that caused me to shake.
I then began to have problems during intercourse with my partner, and due to the discomfort I was experiencing in an increasingly present form, they became correspondingly more and more infrequent, thus deteriorating my sex life.
These discomforts occurred predominantly when I sat for hours at the computer while working.
This experience, alas, lasted almost 1 year, where to be precise in 8 months I performed: 6 urine tests and consulted 2 different urologists. None of whom have ever provided a diagnosis of my problem.
Although my urine tests were ALWAYS all negative, the treatment always resulted in the usual way:
“Madam, take these supplements for four months”, and where fortunately (at this point I have to say it) I was never prescribed antibiotics.
Months went by and, during one of the many sleepless nights I spent due to severe burning, I found several specialised sites surfing the web, such as OSTETRICIA E GINECOLOGIA PER TUTTI and Cystitis.info APS – no profit.
And it was at that precise moment that I decided to go to Dr. Biondo. If only I had thought of it sooner!
Dr. Biondo, not only immediately diagnosed me with a case of vulvodynia, but had me start both pharmacological and instrumental treatments in his practice. He explained to me that they are special tools to combat the disorders related to this ‘strange’ pathology.
Thanks to new treatments with Dr. Biondo, my life is back to the way it was.
I certainly can’t say that it’s all gone, the pains or rather the discomforts occasionally resurface, but I finally got a diagnosis and now I know how to treat it!

Word to the expert: Dr Andrea Biondo – Vulvodynia

DEKA-Intimate: Parola all'esperto Dr. Andrea Biondo - La Vulvodinia

Something is changing: old taboos are wavering, well-known voices are speaking out in first person to break the veil of silence on a disease that affects 1 in 7 women, but is all too often diagnosed with a delay of up to 4/5 years. A nuisance, or more often a pain, that is chronic and affects women’s quality of life, relationships and social life.

It was the influencer Giorgia Soleri, exactly one year ago, who brought the problem to the attention of the media, openly reporting on the Rai 2 programme ‘Tonica’ hosted by Andrea Delogu that she suffers from vulvodynia and how this disorder has negatively affected her life, depriving her of many opportunities. On 28 March 2022, a bill was filed in the Chamber of Deputies calling for the recognition of vulvodynia and pudendal neuropathy as chronic and disabling diseases and their inclusion in the essential levels of care of the National Health Service.

We ask Dr Andrea Biondo, a gynaecologist specialising in fertility, vulvodynia and menopause in Palermo, to explain what vulvodynia is and what symptoms characterise it.

Vulvodynia is a chronic discomfort (or pain) characterised by persistent burning and/or pain at the entrance to the vagina and stiffness of the pelvic floor muscles that can affect women of all ages, from adolescence to menopause. It presents itself without any visible signs or lesions to justify it. And that is why it is more difficult to diagnose, so much so that it is called an ‘invisible disease’. The most common complaints that I have encountered among my patients suffering from vulvodynia and which may be a first indication for diagnosing it are:

  • Vulvar or urethral burning, sometimes preventing the wearing of trousers or tight clothing
  • Irritation
  • Pin feeling
  • Electric shocks or spasms in the vagina
  • Generalised dryness, itching, swelling or discomfort
  • Pain during the sexual act
  • Pain that increases when sitting, perhaps when sitting in the car for a long time

What should be done in the presence of these disorders?

In the presence of one or more of these symptoms, one should first speak to a gynaecologist experienced in this condition, who will arrange for a series of gynaecological check-ups, including a vaginal swab. A delay in diagnosis causes a deterioration in quality of life, sexual relations and, above all, health problems with the intensification of muscle spasms. It is important to recognise the symptoms and intervene early. My way of dealing with this pathology is multimodal, i.e. I use both pharmacological therapies and state-of-the-art devices such as magnetotherapy or fractional laser.

Can you explain in more detail what this is all about?

Depending on the particular situation of each patient, I use customised galenic preparations in which I include drugs to treat pudendal neuropathy combined with the use of innovative devices such as the Dr Arnold electromagnetic field chair and the DuoGlide fractional CO2 laser. Dr Arnold’s new electromagnetic field technology has a decontracting action on the pelvic muscles and is useful for restoring neuromuscular control. The treatment is non-invasive, has no post-treatment recovery time and the patient remains comfortably seated and clothed during the therapy.

The MonalisaGlide treatment, thanks to the fractional CO2 laser, makes it possible to decrease the number of nerve endings that the diseased nerve multiplies pathologically and at the same time to create new collagen in the treated area. Again, this is a minimally invasive procedure, which does not involve any anaesthesia and allows a rapid resumption of daily activities. Patients who follow this course of treatment correctly and for about four months generally have a good remission of their symptoms and are able to live a satisfactory personal and relational life for a long time.

Vulvodynia, Francesca’s story

DEKA Intimate - IntimateStory Francesca
“After sexual intercourse I felt such pain that I could not walk. Francesca’s vulvodynia: “I changed 8 gynaecologists in one year”

 

There are many stories of girls suffering from “invisible diseases” affecting the pelvic floor that are still little known even in the medical field. Francesca decided to tell her story: “My head is always ready to feel pain. Immediately after every intercourse I would get cystitis”

“I started to have cystitis after sexual intercourse. But then the discomfort lasted for the following weeks. My head is always ready to feel pain”. Francesca was diagnosed with vulvodynia and pelvic floor contracture. She is a 32-year-old Roman girl who, when she started to notice the first symptoms, tried to talk to her family and doctor but: “It took a long time before someone started to understand me, I felt extremely lonely”.


“I started to have the first pains in 2020”, says Stefania. Immediately after every intercourse I would get cystitis, which was always treated with antibiotics. But then the bacterial infections, such as candida, also started. During intercourse I feel burning and like pins inside my vagina”.
A pain that seems to be “unbearable” at times. “There are periods when I cannot have sex, others when the discomfort is “bearable”. And when I succeed I feel “powerful”. But most of the time I don’t enjoy the moment, my head is always ready to feel pain, which remains so strong in the following weeks that I struggle even to walk”.

 

With this type of disease, contact with certain types of tissue is also difficult: “I cannot wear jeans, but neither any other loose trousers. I have to wear trousers with a low crotch and sweatpants”.
It was difficult to reach a diagnosis quickly. “I was desperate”, she continues. I changed about 8 gynaecologists in the area in one year. No one understood what I had: all they talked about was mucous membrane changes that needed to be revitalised. Or they would tell me that I had nothing, that maybe I had just had a love disappointment and that it was therefore a psychological problem”.

 

It is only after a year that Francesca finally finds an answer from a specialised gynaecologist. “Thus began my course of physiotherapy and rehabilitation for the pelvic floor with Dr. Arnold, a treatment based on special electromagnetic stimulation (TOP FMS) that consists of sitting in a very comfortable chair!”
So far I have done five sessions, I still have to do at least a couple more, but I feel that my pelvic floor muscles are much more relaxed.
The treatment is pleasant and it was a discovery to feel the pelvic floor muscles, they are muscles I didn’t even think I had and yet they are essential!
The feeling is really one of liberation and I am also starting to let go even during sexual intercourse.”

Word from the expert: Dr. Antonella Curcio – Vulvodynia

DEKA Intimate Word from the expert - Dr. Antonella Curcio
Let’s not resign ourselves to chronic pelvic pain

“The diagnosis of chronic pelvic pain is an admission of diagnostic and therapeutic failure”: this is a harsh statement by Dr. Antonella Curcio, a gynaecologist who has been dealing with women’s intimate health for over 40 years, with a focus on listening to the painful situations that patients very often report to her.
Vulvodynia is a chronic pain syndrome that affects 12-15% of women in the world population. In Italy, a woman consults at least 7 doctors to get a correct diagnosis and about 30% fail to get it. A pathology that heavily affects women’s quality of life, social and couple relationships and that often remains hidden behind many taboos.

 

We talk about this with Dr. Antonella Curcio, gynaecologist and expert in gynaecological endocrinology, menopause and urinary incontinence in Florence

What do you mean by “diagnostic and therapeutic failure”?

By the time a woman comes to develop chronic pelvic pain, she has already had one or more ongoing pathologies for years. Pain is a symptom that is too often disregarded in a simplistic and frequent way in relation to the female patient who “has pain in her head”.
Chronic pain activates a kind of perverse loop, which, like a cyclone, is self-feeding, increasingly affecting a woman’s sexuality and, in particular, her sexual identity, sexual function and relationship.
If we do not understand this and do not intervene in time, the fire – because inflammation is a biochemical fire – changes its face and spreads. The tissue damage caused by the inflammation extends to the nerve fibres to the point of creating a kind of short circuit in the pathways of the transfer of the electrical impulses of pain. And so the pain appears to be of far greater intensity than one would expect.

What can we do not to get to this point?

First of all, the woman must not resign herself to the pain and ask (and demand) help from specialists.
We physicians must pay the utmost attention in the framing of the pathology and its management to achieve results in line with expectations. Listening to patients is fundamental, making them feel at ease even when talking about sensitive topics, without imposing a sometimes mortifying anamnesis. This is a very important point in dealing with the pathology of pain, which in many cases is related to pelvic floor hypertonus caused by the body’s defensive contraction in the event of pain.
Today we have therapeutic opportunities offered by technology, scientifically tested, which help us to improve the quality of life of patients.

A lot is said about vulvodynia, even creating some confusion. It is a very complex pathology, involving physical, pathological and psychological aspects. What resources are available to combat vulvodynia related to pelvic floor hypertonus?

I use the Dr Arnold device, a therapeutic chair that, thanks to its specific protocol for decontracting the muscles, is effective in improving vulvodynia related to pelvic floor hypertonus. In a nutshell, using this protocol results in a kind of technological physiotherapy: Dr Arnold emits electromagnetic waves that selectively stimulate muscle bundles, inducing very intense contractions and producing a relaxation of muscle tone until the tissue is rebalanced. The patient during the treatment, thanks to the induced contractions, also learns about mostly unknown muscles. This is why we talk about re-educational treatment and rehabilitation.
The results are excellent, also because the patient, dressed and comfortably seated, is very relaxed, feels no pain or discomfort and this contributes to the machine’s decontracting action.