What is PVD?

 

PVD is a medical condition that results in distressing pain in the area around the vagina, brought on by touching. It’s a type of Vulvodynia, which is simply Latin for “pain in the external female genitals”. PVD stands for Provoked Vestibulodynia, and is one of the most common forms of this type of pain. The “provoked” part of PVD means the pain comes as a result of physical contact, even very light touching. (The unprovoked type is called Dysesthetic Vulvodynia.)

PVD is still poorly understood, and it’s a tricky disease to identify. Many medical professionals, even gynecologists who specialize in genital health, are not trained to look for PVD and fail to recognize it. For the same reasons, patients often feel they are inventing this very real condition. The intention here is to educate people about the syptoms and causes of PVD so they can seek the right treatment.

Let me be clear. There's no question that PVD exists. There's also no question that it can be cured.

What we know so far is that PVD is a chronic disease – meaning it lasts a long time or comes back frequently. You can recognize it by a burning pain in response to light pressure around the “vestibule” of the vagina (the region between the inner lips of the vagina, which includes the opening of the urinary tract, the vagina and some glands). The characteristic burning sensation is what was first observed and led to the definition of the syndrome.

It is very similar to the burning sensation a woman experiences during childbirth when her vagina is stretched by the crowning of the baby's head; something I often hear about in the delivery room. As a consistent symptom of PVD, it's the burning sensation that an expert will be looking for, specifically, when making a diagnosis of PVD. All cases of PVD involve this tell-tale symptom, so when I see a patient for the first time, I will ask a lot of questions about the specific sensations and types of discomfort she experiences, because I need to know exactly what type of pain is present.

I also want to know about the onset and pattern of the disease – in other words, what was going on in a patient's life when the pain first announced itself, and how often and when it occurs. Bear in mind, however, that the pain may not necessarily be limited to the vulvar vestibule, and may involve the wider area of the external genitalia.

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